Abstract

Topical medication remains the first line treatment of glaucoma; however, sustained ocular drug delivery via topical administration is difficult to achieve. Most drugs have poor penetration due to the multiple physiological barriers of the eye and are rapidly cleared if applied topically. Currently, daily topical administration for lowering the intra-ocular pressure (IOP), has many limitations, such as poor patient compliance and ocular allergy from repeated drug administration. Poor compliance leads to suboptimal control of IOP and disease progression with eventual blindness. The delivery of drugs in a sustained manner could provide the patient with a more attractive alternative by providing optimal therapeutic dosing, with minimal local toxicity and inconvenience. To investigate this, we incorporated latanoprost into LUVs (large unilamellar vesicles) derived from the liposome of DPPC (di-palmitoyl-phosphatidyl-choline) by the film hydration technique. Relatively high amounts of drug could be incorporated into this vesicle, and the drug resides predominantly in the bilayer. Vesicle stability monitored by size measurement and DSC (differential scanning calorimetry) analysis showed that formulations with a drug/lipid mole ratio of about 10% have good physical stability during storage and release. This formulation demonstrated sustained release of latanoprost in vitro, and then tested for efficacy in 23 rabbits. Subconjunctival injection and topical eye drop administration of the latanoprost/liposomal formulation were compared with conventional daily administration of latanoprost eye drops. The IOP lowering effect with a single subconjunctival injection was shown to be sustained for up to 50 days, and the extent of IOP lowering was comparable to daily eye drop administration. Toxicity and localized inflammation were not observed in any treatment groups. We believe that this is the first demonstration, in vivo, of sustained delivery to the anterior segment of the eye that is safe and efficacious for 50 days.

Highlights

  • Glaucoma is the second leading cause of blindness in the world [1]

  • Since glaucoma requires life-long treatment, drug delivery for glaucoma remains a challenging problem, as currently only eye drops are available for topical drug delivery which is associated with very variable therapeutic efficacy and heavily dependent on patient compliance

  • We have evaluated liposomal formulations based on dipalmitoylphosphatidylcholine (DPPC)

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Summary

Introduction

Intraocular pressure (IOP) is the main, modifiable risk factor for this disease. Drugs to treat IOP are classified by the mode of action of the active ingredient eg. Fixed combination drugs are available for patients who require more than one type of medication. Medications used to lower IOP are applied topically, which have poor ocular bioavailability, side effects associated with chronic use (allergic conjunctivitis and dry eyes) and require patient reliance on daily administration [3,4,5,6,7,8]. Since glaucoma requires life-long treatment, drug delivery for glaucoma remains a challenging problem, as currently only eye drops are available for topical drug delivery which is associated with very variable therapeutic efficacy and heavily dependent on patient compliance

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