3D printed, personalized sustained release cortisol for patients with adrenal insufficiency

[Display omitted] The standard of care for patients with Adrenal Insufficiency (AI) is suboptimal. Administration of hydrocortisone three times a day produces plasma cortisol fluctuations associated with negative health outcomes. Furthermore, there is a high inter-individual variability in cortisol...

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Bibliographic Details
Published in:	International journal of pharmaceutics Vol. 630; p. 122466
Main Authors:	Ayyoubi, S., van Kampen, E.E.M., Kocabas, L.I., Parulski, C., Lechanteur, A., Evrard, B., De Jager, K., Muller, E., Wilms, E.W., Meulenhoff, P.W.C., Ruijgrok, E.J.
Format:	Journal Article Web Resource
Language:	English
Published:	Netherlands Elsevier B.V 05-01-2023 Elsevier BV
Subjects:	3D Printing Adrenal Insufficiency Cortisol Fused Deposition Modelling Hot-Melt Extrusion Human health sciences Hydrocortisone Pharmaceutical Science Pharmacie, pharmacologie & toxicologie Pharmacy, pharmacology & toxicology Sciences de la santé humaine
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Summary:	[Display omitted] The standard of care for patients with Adrenal Insufficiency (AI) is suboptimal. Administration of hydrocortisone three times a day produces plasma cortisol fluctuations associated with negative health outcomes. Furthermore, there is a high inter-individual variability in cortisol need, necessitating a personalized approach. It is hypothesized that a personalized, sustained release formulation would enhance the pharmacotherapy by mimicking the physiological cortisol plasma concentration at a higher level. Therefore, a novel 24 h sustained release 3D printed (3DP) hydrocortisone formulation has been developed (M3DICORT) by coupling hot-melt extrusion with fused deposition modeling. A uniform drug distribution in the 3DP tablets is demonstrated by a content of 101.66 ± 1.60 % with an acceptance value of 4.01. Furthermore, tablets had a stable 24 h dissolution profile where the intra-batch standard deviation was ± 2.8 % and the inter-batch standard deviation was ± 6.8 %. Tablet height and hydrocortisone content were correlated (R2 = 0.996), providing a tool for easy dose personalization. Tablets maintained critical quality attributes, such as dissolution profile (f2 > 60) and content uniformity after process transfer from a single-screw extruder to a twin-screw extruder. Impurities were observed in the final product which should be mitigated before clinical assessment. To our knowledge, M3DICORT is the first 3DP hydrocortisone formulation specifically developed for AI.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 scopus-id:2-s2.0-85144588872
ISSN:	0378-5173 1873-3476 1873-3476
DOI:	10.1016/j.ijpharm.2022.122466