Preclinical Investigation of a Lipoglycopeptide Dry Powder Inhalation Therapy for the Treatment of Pulmonary MRSA Infection.

The increased prevalence of pulmonary methicillin-resistant Staphylococcus aureus (MRSA) infection in patients living with cystic fibrosis (CF) is concerning due to a correlation with reduced life expectancy and lack of available treatment options. RV94 is a next generation lipoglycopeptide designed for pulmonary delivery that preclinically demonstrated high potency against MRSA in planktonic and protected colonies and improved pulmonary clearance relative to same class molecules. Here, RV94 was formulated into a dry powder for inhalation (DPI) to investigate the localized treatment of pulmonary MRSA presented in a potentially more convenient dosage form. RV94 DPI was generated using a spray-drying process with 12.5 wt% trileucine and demonstrated aerosol characteristics (2.0 µm MMAD and 73% FPF) predictive of efficient pulmonary deposition. In vivo PK from a single dose of RV94 DPI delivered by inhalation to rats yielded lung levels (127 µg/g) much greater than the MRSA minimum inhibitory concentration (0.063 µg/mL), low systemic levels (0.1 µg/mL), and a lung t1/2 equal to 3.5 days. In a rat acute pulmonary MRSA model, a single dose of RV94 DPI delivered by inhalation either up to seven days prior to or 24 h after infection resulted in a statistically significant reduction in lung MRSA titer.

Large Porous Hollow Particles: Lightweight Champions of Pulmonary Drug Delivery.

The deep lungs provide an efficient pathway for drugs to transport into the systemic circulation, as the extremely large surface area and thin epithelial membrane enable rapid drug transport to the blood stream. To penetrate into the deep lungs, aerosol particles with aerodynamic diameters of 1-3 µm are optimal. Large porous hollow particles (LPHPs) can achieve this aerodynamic size range through enhanced porosity within the particles (typically < 0.4 g/cm(3)), which aerodynamically balances the large particle size (> 5 µm, up to 30 µm). The physical properties of these particles provide some key advantages compared to their small, nonporous counterparts through enhanced dispersibility, efficient deep lung deposition, and avoidance of phagocytic clearance. This review highlights the potential of LPHPs in pulmonary delivery of systemic drugs, with a focus on their critical attributes and key formulation aspects. In addition, three examples of LPHPs under development are presented to emphasize the potential of this technology to treat systemic diseases.