Predicting drug release and degradation kinetics of long-acting microsphere formulations of tacrolimus for subcutaneous injection.

Today, tacrolimus represents a cornerstone of immunosuppressive therapy for liver and kidney transplants and remains subject of preclinical and clinical investigations, aiming at the development of long-acting depot formulations for subcutaneous injection. One major challenge arises from establishing in vitro-in vivo correlations due to the absence of meaningful in vitro methods predictive for the in vivo situation, together with a strong impact of multiple kinetic processes on the plasma concentration-time profile. In the present approach, two microsphere formulations were compared with regards to their in vitro release and degradation characteristics. A novel biorelevant medium provided the physiological ion and protein background. Release was measured using the dispersion releaser technology under accelerated conditions. A release of 100% of the drug from the carrier was achieved within 7 days. The capability of the in vitro performance assay was verified by the level A in vitro-in vivo correlation analysis. The contributions of in vitro drug release, drug degradation, diffusion rate and lymphatic transport to the absorption process were quantitatively investigated by means of a mechanistic modelling approach. The degradation rate, together with release and diffusion characteristics provides an estimate of the bioavailability and therefore can be a guide to future formulation development.

Novel Dissolution Approach for Tacrolimus-Loaded Microspheres Using a Dialysis Membrane for in Vitro-in Vivo Correlation.

The aim of this study was to establish a novel approach to in vitro dissolution evaluation using a combination of the paddle method and a dialysis membrane, both to predict the overall in vivo performance of tacrolimus microspheres and also to identify a suitable dissolution test method to describe the in vivo initial burst phenomenon. This new dissolution method for evaluating the release of tacrolimus from microspheres consisted of rotating a customized paddle inside a dialysis membrane using a conventional paddle apparatus. Findings were compared with a method in which the paddle was rotated outside the dialysis membrane, the conventional paddle method, and the flow-through cell method. We concluded that the paddle method with a dialysis membrane and internal agitation, which was designed to mimic in vivo conditions, predicted the overall pharmacokinetic (PK) profile of tacrolimus microspheres whereas the conventional paddle method described the initial burst. These findings suggest that it may not be possible to predict both the PK profile and initial burst using a single analysis method. We therefore recommend that evaluation of the initial burst be performed separately. In conclusion, we propose that combination of the paddle method with a dialysis membrane and internal agitation to evaluate the overall PK profile, together with the paddle method to describe the in vivo initial burst, represents a novel approach to in vitro dissolution evaluation for microsphere formulations.

A study of appropriate flow rate settings for cell-free and concentrated ascites reinfusion therapy and change of cytokine concentrations in ascites.

We examined appropriate flow rates for high collection rates of Total Protein (TP) and Albumin (Alb) and a change of IL-6 concentrations in the cell-free and concentrated ascites reinfusion therapy (CART) process. No significant changes were observed in IL-6 concentration in the ascites storage test and the circulatory stimulation test. However, it was confirmed that the quantity of IL-6 in the ascites decreased by means of filtration and concentration. In some cases, it quickly reached high concentration rates at a higher flow rate (200 mL/min) setting, but clogging or pressure increase has occurred in the hollow fiber filter. Therefore, it was concluded that a low flow rate (50 mL/min) setting was best and provides safer conditions for filtration and concentration in order to collect TP and Alb effectively and reuse it as autologous protein, which is the primary objective of CART.