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1.
J Nanobiotechnology ; 20(1): 138, 2022 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-35300702

RESUMEN

Unintended pregnancy is a global issue with serious ramifications for women, their families, and society, including abortion, infertility, and maternal death. Although existing contraceptive strategies have been widely used in people's lives, there have not been satisfactory feedbacks due to low contraceptive efficacy and related side effects (e.g., decreased sexuality, menstrual cycle disorder, and even lifelong infertility). In recent years, biomaterials-based long-acting reversible contraception has received increasing attention from the viewpoint of fundamental research and practical applications mainly owing to improved delivery routes and controlled drug delivery. This review summarizes recent progress in advanced biomaterials for long-acting reversible contraception via various delivery routes, including subcutaneous implant, transdermal patch, oral administration, vaginal ring, intrauterine device, fallopian tube occlusion, vas deferens contraception, and Intravenous administration. In addition, biomaterials, especially nanomaterials, still need to be improved and prospects for the future in contraception are mentioned.


Asunto(s)
Anticonceptivos Femeninos , Dispositivos Intrauterinos , Anticoncepción Reversible de Larga Duración , Materiales Biocompatibles , Anticoncepción , Anticonceptivos Femeninos/uso terapéutico , Femenino , Humanos , Embarazo
2.
Doc Ophthalmol ; 138(1): 3-19, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30456454

RESUMEN

PURPOSE: To assess the in vivo release profile and the retinal toxicity of a poly (lactic-co-glycolic acid) (PLGA) sustained-release sirolimus (SRL) intravitreal implant in normal rabbit eyes. METHODS: PLGA intravitreal implants containing or not SRL were prepared, and the viability of ARPE-19 and hES-RPE human retinal cell lines was examined after 24 and 72 h of exposure to implants. New Zealand rabbits were randomly divided into two groups that received intravitreal implants containing or not SRL. At each time point (1-8 weeks), four animals from the SRL group were euthanized, the vitreous was collected, and drug concentration was calculated. Clinical evaluation of the eyes was performed weekly for 8 weeks after administration. Electroretinography (ERG) was recorded in other eight animals, four for each group, at baseline and at 24 h, 1, 4, 6, and 8 weeks after the injection. ERG was carried out using scotopic and photopic protocols. The safety of the implants was assessed using statistical analysis of the ERG parameters (a and b waves, a and b implicit time, B/A ratio, oscillatory potential, and Naka-Rushton analysis) comparing the functional integrity of the retina between the PLGA and SRL-PLGA groups. After the last electrophysiological assessment, the rabbits were euthanized and retinal histopathology was realized. RESULTS: After 24 and 72 h of incubation with PLGA or SRL-PLGA implants, ARPE-19 and hES-RPE cells showed viability over 70%. The maximum concentration of SRL (199.8 ng/mL) released from the device occurred within 4 weeks. No toxic effects of the implants or increase in the intraocular pressure was observed through clinical evaluation of the eye. ERG responses showed no significant difference between the eyes that received PLGA or SRL-PLGA implants at baseline and throughout the 8 weeks of follow-up. No remarkable difference in retinal histopathology was detected in rabbit eyes treated with PLGA or SRL-PLGA implants. CONCLUSIONS: Intravitreal PLGA or SRL-PLGA implants caused no significant reduction in cell viability and showed no evident toxic effect on the function or structure of the retina of the animals. SRL was released from PLGA implant after application in the vitreous of rabbits during 8 weeks.


Asunto(s)
Inmunosupresores/farmacocinética , Inmunosupresores/toxicidad , Epitelio Pigmentado de la Retina/efectos de los fármacos , Sirolimus/farmacocinética , Sirolimus/toxicidad , Cuerpo Vítreo/metabolismo , Implantes Absorbibles , Animales , Disponibilidad Biológica , Línea Celular , Supervivencia Celular , Sistemas de Liberación de Medicamentos , Implantes de Medicamentos , Electrorretinografía , Células Madre Embrionarias/efectos de los fármacos , Humanos , Inyecciones Intravítreas , Copolímero de Ácido Poliláctico-Ácido Poliglicólico , Conejos , Retina/efectos de los fármacos
3.
Proc Natl Acad Sci U S A ; 113(3): 716-21, 2016 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-26729859

RESUMEN

There has been a tremendous amount of research in the past decade to optimize the mechanical properties and degradation behavior of the biodegradable Mg alloy for orthopedic implant. Despite the feasibility of degrading implant, the lack of fundamental understanding about biocompatibility and underlying bone formation mechanism is currently limiting the use in clinical applications. Herein, we report the result of long-term clinical study and systematic investigation of bone formation mechanism of the biodegradable Mg-5wt%Ca-1wt%Zn alloy implant through simultaneous observation of changes in element composition and crystallinity within degrading interface at hierarchical levels. Controlled degradation of Mg-5wt%Ca-1wt%Zn alloy results in the formation of biomimicking calcification matrix at the degrading interface to initiate the bone formation process. This process facilitates early bone healing and allows the complete replacement of biodegradable Mg implant by the new bone within 1 y of implantation, as demonstrated in 53 cases of successful long-term clinical study.


Asunto(s)
Implantes Absorbibles , Aleaciones/farmacología , Magnesio/farmacología , Animales , Femenino , Fémur/diagnóstico por imagen , Fémur/ultraestructura , Estudios de Seguimiento , Humanos , Masculino , Osteogénesis/efectos de los fármacos , Implantación de Prótesis , Conejos , Radiografía , Factores de Tiempo , Cicatrización de Heridas/efectos de los fármacos
4.
BMC Musculoskelet Disord ; 20(1): 334, 2019 Jul 19.
Artículo en Inglés | MEDLINE | ID: mdl-31319832

RESUMEN

BACKGROUND: Biodegradable implants reduce the likelihood of further surgery for hardware removal and reduce the risks of associated infection and allergy. The purpose of this study is to evaluate the clinical efficacy and determine the comparability of biodegradable magnesium alloy MgYREZr (MAGNEZIX® CS) compression screw fixation compared with standard titanium screw fixation in the surgical treatment of hallux valgus deformity. METHODS: Eleven patients undergoing corrective surgery for hallux valgus utilising biodegradable magnesium screws and a control group of 25 patients undergoing corrective hallux valgus surgery with standard titanium screws were reviewed at a median of 19 months (range 12-30 months). PROM scores (Manchester-Oxford Foot Questionnaire (MOXFQ), Foot and Ankle Outcomes Instrument (FAOI) and the EQ-5D-3 L) were recorded preoperatively and at latest follow-up. RESULTS: The results between the two groups were broadly similar, with the Magnesium and Titanium patients showing similar patterns in the various domains in the MOXFQ, the FAOI and the EQ-5D-3 L. Most patients reported a near full shoe comfort score, and EQ-5D-3 L scores were significantly improved in both patient groups (with most patients reporting a full score). Foot pain and foot function improved irrespective of the scoring systems and patients in both groups demonstrated significantly improved scores following the surgery (p < 0.05). Notably, there were no significant differences when comparing the post-operative scores between the groups for any individual scoring parameter. No impairment to quality of life was recorded. There were no intra or post-operative complications. There were no problems encountered through the use of the bioabsorbable screws. CONCLUSION: Biodegradable magnesium-based compression screws appeared to be safe in this study and are an effective fixation device in the treatment of hallux valgus deformity with clinical outcomes similar to standard titanium screw fixation.


Asunto(s)
Hallux Valgus/cirugía , Dolor Musculoesquelético/diagnóstico , Osteotomía/instrumentación , Procedimientos de Cirugía Plástica/instrumentación , Implantes Absorbibles/efectos adversos , Adulto , Tornillos Óseos/efectos adversos , Femenino , Estudios de Seguimiento , Pie/fisiopatología , Hallux Valgus/complicaciones , Hallux Valgus/fisiopatología , Humanos , Magnesio/efectos adversos , Masculino , Persona de Mediana Edad , Dolor Musculoesquelético/etiología , Dolor Musculoesquelético/cirugía , Osteotomía/efectos adversos , Osteotomía/métodos , Dimensión del Dolor , Periodo Posoperatorio , Procedimientos de Cirugía Plástica/efectos adversos , Procedimientos de Cirugía Plástica/métodos , Recuperación de la Función , Estudios Retrospectivos , Titanio/efectos adversos , Resultado del Tratamiento , Caminata/fisiología
5.
Mater Lett ; 244: 203-206, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-31871366

RESUMEN

In this study, the effect of grain size and precipitates on tensile properties of Zn-1.0Cu alloy were investigated. The alloy was cold rolled and annealed to manipulate the grain size and precipitation of CuZn4 particles at grain boundaries. Cold rolling resulted in an almost ultrafinegrained structure alongside precipitation of nano-sized CuZn4 particles. Strain induced precipitates triggered room temperature superplasticity through activation of Zn/CuZn4 boundary sliding, exhibiting maximum elongation of 470% at the strain rate of 1.0 × 10-4 s-1. Short-time annealing led to significantly reduced strain rate sensitivity due to the reduction of CuZn4 fraction, while the grain size remained nearly intact. This suggests that precipitates rather than grain size mainly influence the mechanical properties of Zn alloys.

6.
Foot Ankle Surg ; 25(3): 398-405, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30321972

RESUMEN

BACKGROUND: Various implants, for example K-wires, screws, plates or staples, have been introduced for the stabilisation of corrective osteotomies in hallux valgus surgery. To provide high initial stability and to avoid subsequent implant removal, a novel biodegradable magnesium screw (MAGNEZIX® CS, Syntellix AG, Hanover, Germany) has been developed and approved for clinical use. METHODS: Between October 2014 and June 2016, magnesium screws were used in 100 patients with a symptomatic hallux valgus deformity for the fixation of Chevron and Youngswick osteotomies. The results were compared to a retrospective cohort of 100 patients, in which titanium screws were applied to stabilize the osteotomies in a comparable manner. All follow-up data was collected retrospectively. RESULTS: Both cohorts showed no differences concerning the age of patients, comorbidities, number of corrected toes and duration of surgery. The median clinical follow up was 12.2 weeks (magnesium) and 11.7 weeks (titanium), respectively. No difference was found between the magnesium screws and the titanium screws in respect to prolonged wound healing or deep infection. One patient complained about a prominent screw head in the titanium group and one screw fracture was noticed in the magnesium group most probably due to early full weight bearing. All patients but four could start full weight bearing in normal shoes at six weeks. CONCLUSIONS: Early results of 100 cases of biodegradable magnesium screws in hallux valgus surgery show non-inferior results concerning clinical outcome and complications compared to titanium alloy screws. To avoid implant removal, while keeping high initial stability, magnesium screws are an excellent option in hallux valgus surgery.


Asunto(s)
Tornillos Óseos , Hallux Valgus/cirugía , Magnesio , Huesos Metatarsianos/cirugía , Osteotomía/instrumentación , Titanio , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteotomía/métodos , Estudios Retrospectivos
7.
BMC Ophthalmol ; 18(1): 60, 2018 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-29486746

RESUMEN

BACKGROUND: To report the results of the repair of conjunctival erosions resulting from glaucoma drainage device surgery using collagen-glycosaminoglycane matrices (CGM). METHODS: Case series of 8 patients who underwent revision surgery due to conjunctival defects with exposed tubes through necrosis of the overlying scleral flap and conjunctiva after Baerveldt drainage device surgery. The defects were repaired by lateral displacement of the tube towards the sclera, with a slice of a CGM as a patch, covered by adjacent conjunctiva. RESULT: Successful, lasting closure (follow-up of 12 to 42 months) of the conjunctival defects was achieved without any side-effects or complications in all eight cases. CONCLUSIONS: Erosion of the drainage tube, creating buttonholes in the conjunctiva after implantation of glaucoma drainage devices, is a potentially serious problem. It can be managed successfully using a biodegradable CGM as a patch.


Asunto(s)
Colágeno/uso terapéutico , Conjuntiva/lesiones , Conjuntiva/cirugía , Implantes de Drenaje de Glaucoma/efectos adversos , Glaucoma/cirugía , Glicosaminoglicanos/uso terapéutico , Procedimientos Quirúrgicos Oftalmológicos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Presión Intraocular , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/cirugía , Reoperación , Estudios Retrospectivos , Esclerótica/cirugía
8.
Pharm Res ; 33(7): 1649-56, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26975357

RESUMEN

PURPOSE: The effectiveness of Tenofovir based HIV pre-exposure prophylaxis (PrEP) is proven, but hinges on correct and consistent use. User compliance and therapeutic effectiveness can be improved by long acting drug delivery systems. Here we describe a thin-film polymer device (TFPD) as a biodegradable subcutaneous implant for PrEP. METHODS: A thin-film polycaprolactone (PCL) membrane controls drug release from a reservoir. To achieve membrane controlled release, TAF requires a formulation excipient such as PEG300 to increase the dissolution rate and reservoir solubility. Short-term In vitro release studies are used to develop an empirical design model, which is applied to the production of in vitro prototype devices demonstrating up to 90-days of linear release and TAF chemical stability. RESULTS: The size and shape of the TFPD are tunable, achieving release rates ranging from 0.5 to 4.4 mg/day in devices no larger than a contraceptive implant. Based on published data for oral TAF, subcutaneous constant-rate release for HIV PrEP is estimated at <2.8 mg/day. Prototype devices demonstrated linear release at 1.2 mg/day for up to 90 days and at 2.2 mg/day for up to 60 days. CONCLUSIONS: We present a biodegradable TFPD for subcutaneous delivery of TAF for HIV PrEP. The size, shape and release rate of the device are tunable over a >8-fold range.


Asunto(s)
Adenina/análogos & derivados , Plásticos Biodegradables/química , Fumaratos/química , VIH-1/efectos de los fármacos , Polímeros/química , Adenina/química , Adenina/farmacología , Alanina , Fármacos Anti-VIH/química , Fármacos Anti-VIH/farmacología , Química Farmacéutica/métodos , Preparaciones de Acción Retardada/química , Preparaciones de Acción Retardada/farmacología , Sistemas de Liberación de Medicamentos/métodos , Liberación de Fármacos/fisiología , Tamaño de la Partícula , Poliésteres/química , Profilaxis Pre-Exposición/métodos , Solubilidad , Tenofovir/análogos & derivados
9.
Doc Ophthalmol ; 131(3): 207-14, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26576763

RESUMEN

PURPOSE: To determine the in vivo release profile and retinal safety of cyclosporine A (CsA) delivered from a biodegradable poly-lactide-co-glycolide (PLGA) device in the vitreous cavity of rabbits' eyes. METHODS: A total of 60 animals (60 eyes) divided into two groups were used. For the in vivo release study, 32 eyes received PLGA implants containing 350 µg of CsA, and 16 eyes received the implants without drug (control). Four animals of CsA group and two of the control group were killed weekly until 8 weeks; the vitreous was removed, and CsA concentration was evaluated. Ophthalmological examination was performed in the animals prior to implant placement and weekly during the study period. Electroretinography (ERG) was performed in other six animals for each group, treated and control, at the beginning and at the end of the study (8 weeks) when they were killed and had their eyes processed for histology. RESULTS: No sign of inflammation was noticed on slit lamp examinations and the IOP maintained stable during the study period in CsA and control groups. CsA concentration in the vitreous (ng/ml) was 257.07 ± 117.23, 271.15 ± 98.96, 296.66 ± 86.25, 256.27 ± 99.22, 304.50 ± 88.18, 326.35 ± 105.24, 491.25 ± 119.90 and 589.93 ± 132.55 after 1, 2, 3, 4, 5, 6, 7 and 8 weeks of implantation, respectively. At the end of the study, 21.67 % of mass loss was found. The retina did not show any histological alteration in either group, but a significant reduction in dark-adapted b-wave amplitude was observed in the CsA group, with no changes in a-wave amplitude. CONCLUSIONS: These data show that the PLGA system is safe, but the selective reduction in ERG b-wave amplitude indicates that the PLGA with 350 µg CsA causes retinal function impairment, specifically on the rod postreceptor pathway, 8 weeks after implantation. These ERG changes were not associated with any histological damage as seen at the light microscopy level.


Asunto(s)
Ciclosporina/farmacocinética , Ciclosporina/toxicidad , Portadores de Fármacos , Inmunosupresores/farmacocinética , Inmunosupresores/toxicidad , Retina/efectos de los fármacos , Cuerpo Vítreo/metabolismo , Implantes Absorbibles , Animales , Cromatografía Líquida de Alta Presión , Implantes de Medicamentos , Electrorretinografía , Ácido Láctico , Ácido Poliglicólico , Copolímero de Ácido Poliláctico-Ácido Poliglicólico , Conejos , Retina/fisiopatología
10.
J Biomater Appl ; : 8853282241257183, 2024 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-38816339

RESUMEN

Addressing fracture-related infections (FRI) and impaired bone healing remains a significant challenge in orthopedics and stomatology. Researchers aim to address this issue by utilizing biodegradable biomaterials, such as magnesium/poly lactic acid (Mg/PLA) composites, to offer antibacterial properties during the degradation of biodegradable implants. Existing Mg/PLA composites often lack sufficient Mg content, hindering their ability to achieve the desired antibacterial effect. Additionally, research on the anti-inflammatory effects of these composites during late-stage degradation is limited. To strengthen mechanical properties, bolster antibacterial efficacy, and enhance anti-inflammatory capabilities during degradation, we incorporated elevated Mg content into PLA to yield Mg/PLA composites. These composites underwent in vitro degradation studies, cellular assays, bacterial tests, and simulation of the PLA degradation microenvironment. 20 wt% and 40 wt% Mg/PLA composites displayed significant antibacterial properties, with three composites exhibiting notable anti-inflammatory effects. In contrast, elevated Mg content detrimentally impacted mechanical properties. The findings suggest that Mg/PLA composites hold promise in augmenting antibacterial and anti-inflammatory attributes within polymers, potentially serving as temporary regenerative materials for treating bone tissue defects complicated by infections.

11.
Clin Ophthalmol ; 18: 187-199, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38263954

RESUMEN

Purpose: A sustained-release, biodegradable, intracameral 10-µg bimatoprost implant (Durysta) is approved for single administration per eye to lower intraocular pressure (IOP) in open-angle glaucoma (OAG) and ocular hypertension (OHT). The purpose of this study was to evaluate the IOP-lowering effectiveness and safety of a single implant administration per eye in patients with OAG or OHT in a real-world clinical setting. Methods: This was a retrospective, single-site study involving 105 consecutive adult patients with OAG or OHT treated with the bimatoprost implant in 1 or both eyes in routine clinical practice. Available medical records of the patients for 12 months or longer after the initial implant administration were reviewed, and data including IOP, IOP-lowering medication and procedure use, and safety outcomes were collected and analyzed. The analysis used ranges of follow-up because of the real-world setting. Results: The study included 197 eyes (85.3% diagnosed with OAG, 94.9% pseudophakic, and 83.8% with angle grade 4). IOP reduction was observed through 1 year after the bimatoprost implant administration. Mean IOP was 16.6 mmHg at baseline and 13.3 mmHg at 11-13 months, with the mean number of topical IOP-lowering medications used reduced from 1.4 at baseline to 0.2 at 11-13 months. IOP and IOP-lowering medication use were similarly reduced in eyes treated with both selective laser trabeculoplasty (SLT) and bimatoprost implant (including 66 eyes with their last SLT before implant administration and 28 eyes with their last SLT after implant administration). There were no cases of treatment-emergent corneal edema after bimatoprost implant administration, and no eye required implant removal. Conclusion: A single bimatoprost implant administration safely and effectively reduced IOP for up to 1 year and decreased the need for topical IOP-lowering medications in eyes with OAG or OHT with or without previous or subsequent SLT.

12.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 38(3): 380-386, 2024 Mar 15.
Artículo en Zh | MEDLINE | ID: mdl-38500435

RESUMEN

Objective: To review the research progress of magnesium and magnesium alloy implants in the repair and reconstruction of sports injury. Methods: Relevant literature of magnesium and magnesium alloys for sports injury repair and reconstruction was extensively reviewed. The characteristics of magnesium and its alloys and their applications in the repair and reconstruction of sports injuries across various anatomical sites were thoroughly discussed and summarized. Results: Magnesium and magnesium alloys have advantages in mechanical properties, biosafety, and promoting tendon-bone interface healing. Many preclinical studies on magnesium and magnesium alloy implants for repairing and reconstructing sports injuries have yielded promising results. However, successful clinical translation still requires addressing issues related to mechanical strength and degradation behavior, where alloying and surface treatments offer feasible solutions. Conclusion: The clinical translation of magnesium and magnesium alloy implants for repairing and reconstructing sports injuries holds promise. Subsequent efforts should focus on optimizing the mechanical strength and degradation behavior of magnesium and magnesium alloy implants. Conducting larger-scale biocompatibility testing and developing novel magnesium-containing implants represent new directions for future research.


Asunto(s)
Traumatismos en Atletas , Medicina Deportiva , Humanos , Magnesio , Aleaciones , Prótesis e Implantes , Ensayo de Materiales , Implantes Absorbibles , Corrosión
13.
ACS Biomater Sci Eng ; 9(7): 4255-4268, 2023 07 10.
Artículo en Inglés | MEDLINE | ID: mdl-37452568

RESUMEN

The biocompatibility and biodegradation of iron (Fe) make it a suitable candidate for developing biodegradable metallic implants. However, the degradation rate of Fe in a physiological environment is extremely slow and needs to be enhanced to a rate compatible with tissue growth. Incorporating noble metals improves the Fe degradation rate by forming galvanic couples. This study incorporated gold (Au) into Fe at very low concentrations of 1.25 and 2.37 µg/g to improve the degradation rate. The electrochemical corrosion test of the samples revealed that the Au-containing samples showed a four-time and nine-time faster degradation rate than pure Fe. Furthermore, the immersion test and long-term electrochemical impedance spectroscopy conducted in simulated body fluid (SBF) revealed that the Au-incorporated samples exhibited increased bioactivity and degraded faster than pure Fe. Integrating nanogold into a Fe matrix increased the in situ formation of hydroxyapatite on the sample's surface and did not cause toxicity to L929-murine fibroblast cells. It is suggested that Fe-Au composites with low concentrations of Au can be used to tailor the biodegradation rate and promote the biomineralization of Fe-based implants in the physiological environment.


Asunto(s)
Materiales Biocompatibles , Hierro , Animales , Ratones , Hierro/química , Ensayo de Materiales , Implantes Absorbibles , Oro/química , Biomineralización
14.
Materials (Basel) ; 16(15)2023 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-37570096

RESUMEN

Medical devices intended for implantation must be, in accordance with the legal provisions in force in the European Union, sterile. The effect of sterilization on the structural and thermal properties of implants, made by 3D printing from biodegradable polylactide and hydroxyapatite in a proportion of 9/1 by weight, was evaluated. The implants were sterilized using three different methods, i.e., steam sterilization, ethylene oxide sterilization, and electron beam radiation sterilization. As a result of the assessment of the structural properties of the implants after sterilization, a change in the molecular weight of the raw material of the designed implants was found after each of the performed sterilization methods, while maintaining similar characteristics of the thermal properties and functional groups present.

15.
Ophthalmol Glaucoma ; 6(6): 599-608, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37343625

RESUMEN

PURPOSE: To evaluate the effects of a single bimatoprost implant administration on 24-hour intraocular pressure (IOP) lowering at 8 weeks, and 1-year IOP-lowering efficacy and safety outcomes. DESIGN: Multicenter, open-label, 12-month, phase 3b study (NCT04285580). PARTICIPANTS: Adults with open-angle glaucoma or ocular hypertension. METHODS: Participants (n = 31) received 10-µg bimatoprost implant in the study eye on day 1; IOP (sitting and/or supine) was measured with pneumatonometry every 2 hours throughout a 24-hour period at baseline and week 8. IOP was measured by Goldmann applanation tonometry (GAT) at hour 0 (8 am ± 1 hour) at baseline, weeks 8 and 16, and months 6, 9, and 12. MAIN OUTCOME MEASURES: The primary endpoint was the week-8 hour-matched change from baseline in habitual position IOP over 24 hours assessed with pneumatonometry. Hour 0 IOP change from baseline measured with GAT in study eyes that received no additional (rescue) IOP-lowering treatment, treatment-emergent adverse events (TEAEs), and central corneal endothelial cell density (CECD) were evaluated through 12 months. RESULTS: The mean (standard deviation [SD]) baseline IOP at hour 0 was 24.2 (2.70) mmHg and 25.3 (7.15) mmHg by GAT and pneumatonometry, respectively. Pneumatonometer measurements of IOP taken over 24 hours at week 8 with the participant in habitual position (sitting from 8 am to 10 pm, supine from 12 am to 6 am) showed consistent IOP lowering through the day and night and reduced fluctuation in IOP. The range in IOP measurements over 24 hours was reduced from baseline by a mean (SD) of -1.6 (2.98) mmHg. All 31 bimatoprost implant-treated participants completed the 12-month study; 23 (74%) required no rescue IOP-lowering treatment. The mean (SD) IOP reduction from baseline at month 12 in nonrescued eyes was -4.3 (3.35) mmHg. The most common TEAE was conjunctival hyperemia (incidence 35.5%, 11/31). No implant-treated eye had a ≥ 15% loss in CECD from baseline. CONCLUSIONS: A single intracameral administration of the bimatoprost implant lowered IOP in the habitual position consistently throughout the day and night at week 8. The majority of participants continued to have reduced IOP for 1 year without additional therapy. The 1-year safety profile was favorable. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.


Asunto(s)
Glaucoma de Ángulo Abierto , Hipotensión Ocular , Adulto , Humanos , Bimatoprost/farmacología , Presión Intraocular , Glaucoma de Ángulo Abierto/tratamiento farmacológico , Glaucoma de Ángulo Abierto/cirugía , Antihipertensivos/uso terapéutico , Cloprostenol/efectos adversos , Amidas/efectos adversos
16.
J Ocul Pharmacol Ther ; 39(1): 55-62, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36378864

RESUMEN

Purpose: To evaluate the time course of biodegradation of an intracameral, biodegradable, sustained-release bimatoprost implant that lowers intraocular pressure without the need for daily eye drops. Methods: In 2 identically designed, randomized, phase 3 clinical trials, adults with open-angle glaucoma or ocular hypertension and open iridocorneal angles inferiorly in the study eye were administered 10- or 15-µg bimatoprost implant (day 1 and weeks 16 and 32) or twice-daily topical timolol 0.5%. Implants were assessed on gonioscopy throughout the studies. Investigators reported whether implants were visible, estimated the size of visible implants relative to their initial size at implantation, and reported the implant location. Data for 10-µg implant placed on day 1 were pooled from both studies for analysis. Results: A total of 372 patients received the 10-µg bimatoprost implant. The degree of implant biodegradation at each follow-up time point was variable among patients. The implant frequently swelled during the initial phase of biodegradation from 6 to 28 weeks. Accelerated biodegradation occurred between 31 and 52 weeks, resulting in 82% of implants absent or ≤25% of initial size by 52 weeks. By month 20, 95% of implants had biodegraded to absent or ≤25% of initial size. The implant was predominantly located inferiorly in the iridocorneal angle. Conclusions: Bimatoprost implant biodegradation in phase 3 studies showed some degree of variability among patients. Clinically significant implant biodegradation was observed in the majority of patients by 12 months. Clinical studies are in progress to further understand implant biodegradation and the ideal timing for implant re-administration. ClinicalTrials.gov NCT02247804; ClinicalTrials.gov NCT02250651.


Asunto(s)
Glaucoma de Ángulo Abierto , Glaucoma , Hipertensión Ocular , Adulto , Humanos , Amidas/uso terapéutico , Antihipertensivos/uso terapéutico , Bimatoprost/uso terapéutico , Cloprostenol/uso terapéutico , Glaucoma/tratamiento farmacológico , Glaucoma de Ángulo Abierto/tratamiento farmacológico , Glaucoma de Ángulo Abierto/cirugía , Presión Intraocular , Hipertensión Ocular/tratamiento farmacológico , Timolol/uso terapéutico
17.
Pharmaceutics ; 15(12)2023 11 26.
Artículo en Inglés | MEDLINE | ID: mdl-38140017

RESUMEN

The prevention of HIV and unintended pregnancies is a public health priority. Multi-purpose prevention technologies capable of long-acting HIV and pregnancy prevention are desirable for women. Here, we utilized a preclinical macaque model to evaluate the pharmacokinetics of biodegradable ε-polycaprolactone implants delivering the antiretroviral islatravir (ISL) and the contraceptive etonogestrel (ENG). Three implants were tested: ISL-62 mg, ISL-98 mg, and ENG-33 mg. Animals received one or two ISL-eluting implants, with doses of 42, 66, or 108 µg of ISL/day with or without an additional ENG-33 mg implant (31 µg/day). Drug release increased linearly with dose with median [range] plasma ISL levels of 1.3 [1.0-2.5], 1.9 [1.2-6.3] and 2.8 [2.3-11.6], respectively. The ISL-62 and 98 mg implants demonstrated stable drug release over three months with ISL-triphosphate (ISL-TP) concentr54ations in PBMCs above levels predicted to be efficacious for PrEP. Similarly, ENG implants demonstrated sustained drug release with median [range] plasma ENG levels of 495 [229-1110] pg/mL, which suppressed progesterone within two weeks and showed no evidence of altering ISL pharmacokinetics. Two of the six ISL-98 mg implants broke during the study and induced implant-site reactions, whereas no reactions were observed with intact implants. We show that ISL and ENG biodegradable implants are safe and yield sufficient drug levels to achieve prevention targets. The evaluation of optimized implants with increased mechanical robustness is underway for improved durability and vaginal efficacy in a SHIV challenge model.

18.
Bioact Mater ; 28: 155-166, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37250865

RESUMEN

The microstructural architecture of remodeled bone in the peri-implant region of screw implants plays a vital role in the distribution of strain energy and implant stability. We present a study in which screw implants made from titanium, polyetheretherketone and biodegradable magnesium-gadolinium alloys were implanted into rat tibia and subjected to a push-out test four, eight and twelve weeks after implantation. Screws were 4 mm in length and with an M2 thread. The loading experiment was accompanied by simultaneous three-dimensional imaging using synchrotron-radiation microcomputed tomography at 5 µm resolution. Bone deformation and strains were tracked by applying optical flow-based digital volume correlation to the recorded image sequences. Implant stabilities measured for screws of biodegradable alloys were comparable to pins whereas non-degradable biomaterials experienced additional mechanical stabilization. Peri-implant bone morphology and strain transfer from the loaded implant site depended heavily on the biomaterial utilized. Titanium implants stimulated rapid callus formation displaying a consistent monomodal strain profile whereas the bone volume fraction in the vicinity of magnesium-gadolinium alloys exhibited a minimum close to the interface of the implant and less ordered strain transfer. Correlations in our data suggest that implant stability benefits from disparate bone morphological properties depending on the biomaterial utilized. This leaves the choice of biomaterial as situational depending on local tissue properties.

19.
Pharmaceutics ; 15(7)2023 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-37514137

RESUMEN

The eye's intricate anatomical barriers pose significant challenges to the penetration, residence time, and bioavailability of topically applied medications, particularly in managing uveitis and neuro-ophthalmologic conditions. Addressing this issue, polymeric nano-based drug delivery systems (DDS) have surfaced as a promising solution. These systems enhance drug bioavailability in hard-to-reach target tissues, extend residence time within ocular tissues, and utilize biodegradable and nanosized polymers to reduce undesirable side effects. Thus, they have stimulated substantial interest in crafting innovative treatments for uveitis and neuro-ophthalmologic diseases. This review provides a comprehensive exploration of polymeric nano-based DDS used for managing these conditions. We discuss the present therapeutic hurdles posed by these diseases and explore the potential role of various biopolymers in broadening our treatment repertoire. Our study incorporates a detailed literature review of preclinical and clinical studies from 2017 to 2023. Owing to advancements in polymer science, ocular DDS has made rapid strides, showing tremendous potential to revolutionize the treatment of patients with uveitis and neuro-ophthalmologic disorders.

20.
Biomech Model Mechanobiol ; 21(5): 1371-1392, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35717547

RESUMEN

In orthopaedics, conventional implant plates such as locking compression plate (LCP) made from non-biodegradable materials play a vital role in the fixation to support bone fractures, but also create a complication such as stress shielding. These again require a painful surgery to remove/replace after they have healed as it does not degrade into the physiological environment (PE). Currently, there has already been enough discovery of biodegradable materials that, despite being mechanically inefficient compared to non-biodegradable materials, can completely be biodegraded in PE during and after healing to avoid such problems. While there has been insufficient research on the design of biodegradable implant plates, the implementation of which may help achieve the goal with an effort of high mechanical strength. A novel design of biodegradable embossed locking compression plate (BELCP) is designed for biodegradable materials to approach superior mechanical performance and complete degradation over time, considering all such parameters and factors. For biomechanical evaluation, four-point bending test (4PBT), axial compressive and tensile test (ACTT) and torsion test (TT) have been performed on LCP, BELCP and its continuously degraded forms made of biodegradable material (Mg-alloy) using finite element method. BELCP has found 50%, 100% and 100% higher mechanical performance and safer in 4PBT, ACTT and TT, respectively, than LCP. Moreover, BELCP has also observed safe during continuous degradation up to 6 months after implantation under these three tests, considering an approximate sustained degradation rate of about 4 mm/year. Even Mg-alloy made BELCP can be sufficient and safer to support fractured bone than SS-alloy made LCP, but not Ti-alloy made LCP. BELCP can be a successful biodegradable bone implant plate after human/animal trials in the future.


Asunto(s)
Fijación Interna de Fracturas , Ortopedia , Animales , Humanos , Análisis de Elementos Finitos , Fijación Interna de Fracturas/métodos , Estrés Mecánico , Fenómenos Biomecánicos , Placas Óseas , Aleaciones
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