Foam drug delivery in dermatology: beyond the scalp
- Authors: Purdon, Carryn H , Haigh, John M , Surber, Christian , Smith, Eric W
- Date: 2003
- Subjects: Adis International Limited , Drug delivery systems , Skin disorders
- Language: English
- Type: text , Article
- Identifier: vital:6418 , http://hdl.handle.net/10962/d1006541
- Description: Consumers of topical formulations apply a wide spectrum of preparations, both cosmetic and dermatological, to their healthy or diseased skin. These formulations range in physicochemical nature from solid through semisolid to liquid. Pharmaceutical foams are pressurized dosage forms containing one or more active ingredients that, upon valve actuation, emit a fine dispersion of liquid and/or solid materials in a gaseous medium. Foam formulations are generally easier to apply, are less dense, and spread more easily than other topical dosage forms. Foams may be formulated in various ways to provide emollient or drying functions to the skin, depending on the formulation constituents. Therefore, this delivery technology should be a useful addition to the spectrum of formulations available for topical use; however, as yet, only a few are commercially available. Probably the most convincing argument for the use of foams is ease of use by the patient, and consumer acceptance. Most foam dosage forms used in dermatology to date have incorporated corticosteroids, although some products have also been used to deliver antiseptics, antifungal agents, anti-inflammatory agents, local anesthetic agents, skin emollients, and protectants. Although there is no clinical evidence that foam formulations are currently superior to other conventional delivery vehicles, these formulations have a clear application advantage and with continued developments in the science of supersaturation technology, it seems certain that foam delivery systems will retain their place in the dermatological and cosmetic armamentarium.
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Quantification of corticosteroid-induced skin vasoconstriction: visual ranking, chromameter measurement or digital image analysis
- Authors: Smith, Eric W , Haigh, John M , Surber, Christian
- Date: 2002
- Language: English
- Type: text , Article
- Identifier: vital:6427 , http://hdl.handle.net/10962/d1006564
- Description: Topical corticosteroid formulations have been evaluated by visual grading protocols for many years. Toward a more objective methodology, several instrumental methods have been evaluated for applicability in quantifying the vasoconstriction side-effect that follows corticosteroid application to the skin. Although the chromameter has been adopted by regulatory bodies throughout the world as the current standard for topical bioequivalence determinations, there is considerable criticism of this instrument from several quarters. A preliminary comparison reported here indicates that digital image analysis provides statistically significant results that are similar to those obtained by visual assessment techniques, and shows considerably greater precision than that obtained by the chromameter. Continued evaluation of objective assessment techniques, such as digital imaging, and continued modernisation of regulatory bioequivalence requirements will assist in protecting patients and optimising clinical results.
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The registration of generic topical corticosteroid formulations in South Africa: a report
- Authors: Haigh, John M , Smith, Eric W
- Date: 2002
- Language: English
- Type: Article
- Identifier: vital:6368 , http://hdl.handle.net/10962/d1006068
- Description: [From the text]Topical corticosteroid formulations are used widely for a variety of skin conditions such as psoriasis and eczema. The most commonly used formulation types are cream, ointment, lotion and scalp application, with some mousse formulations being released recently onto the market for scalp application. The type of formulation used depends on the condition being treated. Dry lesions are normally treated with ointments and wet lesions with creams. Cosmetically, cream formulations are more acceptable as they can be rubbed in, thus leaving no residual oiliness. Scalp applications have to be less viscous to allow the formulation to pass through the hair and contact the scalp. Occlusion with plastic wrapping hydrates the stratum corneum and facilitates the passage of the corticosteroid through this barrier to the basal layer where the therapeutic effect is required.
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Application of the Minolta chromameter to the assessment of corticosteroid-induced skin blanching
- Authors: Walker, Roderick B , Haigh, John M , Smith, Eric W
- Date: 2000
- Language: English
- Type: Book chapter , text
- Identifier: vital:6451 , http://hdl.handle.net/10962/d1006639
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Analysis of chromameter results obtained from corticosteroid-induced skin blanching assay: comparison of visual and chromameter data
- Authors: Schwarb, Fabian P , Smith, Eric W , Haigh, John M , Surber, Christian
- Date: 1999
- Language: English
- Type: text , Article
- Identifier: vital:6426 , http://hdl.handle.net/10962/d1006562
- Description: In a Guidance document, the American FDA recommends the use of a Minolta chromameter rather than the human eye for the quantitative assessment of the pharmacodynamic blanching response produced by topical application of corticosteroids. The purpose of this study was to compare the appropriateness of the human eye and two models of chromameter for the estimation of skin blanching, in terms of the quality of the data generated by each method. The corticosteroid-induced skin blanching from four different betamethasone 17-valerate cream formulations was compared in a typical human skin blanching trial. The optimized assay methodology routinely practised in our laboratories was utilized. The blanching responses were assessed visually by three trained, independent observers and recorded by two chromameters (Minolta model CR-200 and model CR-300). The topical availability of the four creams was determined using visual scoring and chromameter measurements. All data were manipulated in such a manner as to produce a blanching response versus time profile from which AUBC analysis could be performed. Good correlation was observed between the visual assessments made by three independent observers. In contrast, moderate correlation was determined between visual, CR-200 and CR-300 measurements. Surprisingly, no direct linear relationship between the AUBCs produced by the two chromameters was observed indicating that the quality of the data obtained from the two instruments may not be equal. This investigation also indicated that the use of the chromameter is not completely objective. Visual scoring and chromameter measurement produce data sets that differ in quality. Each procedure needs to be validated and investigators have to be trained for both visual assessment and the operation of the chromameter, particularly with regard to the manipulation of the measuring head of the instrument.
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Effect of concentration and degree of saturation of topical fluocinonide formulations on in vitro membrane transport and in vivo availability on human skin
- Authors: Schwarb, Fabian P , Imanidis, Georgios , Smith, Eric W , Haigh, John M , Surber, Christian
- Date: 1999
- Language: English
- Type: text , Article
- Identifier: vital:6425 , http://hdl.handle.net/10962/d1006560
- Description: Purpose. The thermodynamic acitvity of drugs in topical vehicles is considered to significantly influence topical delivery. In vitro diffusion across a synthetic membrane was shown to be correlated to the degree of saturation of the drug in the applied vehicle and therefore offers a potential for increased topical drug delivery. Fluocinonide a topical corticosteroid, was chosen as a model compound to investigate in vitro and in vivo availability from formulations with different degrees of saturation. Methods. Sub-, as well as, supersaturated drug solutions were prepared using PVP as an antinucleant agent. In vitro membrane diffusion experiments across silicone membrane and in vivo pharmacodynamic activity assessments, using the human skin blanching assay, were carried out. Results. Over the concentration range studied, the in vitro membrane transport of fluocinonide was proportional to the degree of saturation of the respective formulations. The in vivo pharmacodynamic response in the human skin blanching assay was related to the concentration of the drug in the vehicle irrespective of the degree of saturation. Conclusions. From the membrane permeation experiment it can be concluded, that the drug flux might be increased supra-proportionally with increasing donor concentration, drug (super-)saturation (proportional), beyond what would be anticipated based on ideal donor concentration and partition coefficient considerations only. These findings could not be confirmed in the in vivo investigation, probably due to additional vehicle effects (e.g., enhancement, irritation, drug binding) which have to be expected and could have altered the integrity of the stratum corneum and therewith topical bioavailability of the drug.
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Analysis of chromameter results obtained from corticosteroid-induced skin blanching. I. Manipulation of data
- Authors: Smith, Eric W , Haigh, John M , Walker, Roderick B
- Date: 1998
- Language: English
- Type: text , Article
- Identifier: vital:6424 , http://hdl.handle.net/10962/d1006559
- Description: Purpose. One of the unresolved issues in the FDA Guidance document for topical corticosteroid bioequivalence testing is the method of manipulation suggested for the chromameter data. The purpose of this study was to manipulate the instrumental data from a typical blanching study in a number of ways to investigate the appropriateness of these procedures for comparison with the subjective visually-assessed results. Methods. The human skin blanching assay methodology routinely practiced in our laboratories was utilised and the vasoconstriction produced by two corticosteroid formulations of different potency was assessed visually and instrumentally by use of a Minolta chromameter. The instrumental data were corrected for zero-time and unmedicated site readings. In addition, Euclidean distances were calculated using all data generated by the instrument. Results. Individually the a-, b- and L-scale chromameter values are imprecise and there is negligible vasoconstriction response recorded for the moderately potent formulation. Arithmetical manipulation of the data as suggested by the FDA does not appear to improve the quality of the data in any way. Euclidean distance analysis more closely resembles the visual data and appears to have better precision. Conclusions. It is clear that mathematical correction of chromameter data is unnecessary, especially since the instrumental data are extremely imprecise. Furthermore, the assessment of each individual chromameter index does not adequately characterise the blanching response profile. It is therefore suggested that Euclidean distance may be a better measure on which to base an analysis of bioequivalence than the truncated data set methodology currently suggested by the FDA.
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Bioequivalence testing of topical dermatological formulations, the gap between science and legislation
- Authors: Schwarb, Fabian P , Smith, Eric W , Haigh, John M , Surber, Christian
- Date: 1998
- Language: English
- Type: Conference paper
- Identifier: vital:6341 , http://hdl.handle.net/10962/d1006608
- Description: Bioavailability concerns for topical dermatological products are complex and it is especially difficult to determine the bioequivalence of similar topical formulations. Since only small amounts of drug dispersed in an appropriate vehicle are applied to the skin, the amount of drug that actually reaches the systemic circulation is often too small to be easily quantified. Additionally, it can be argued that the relevance of any serum/plasma concentration-time curve of a topical agent is questionable, since the curve reflects the amount of drug after the active moiety has left the site of action. For some topical drugs e.g., topical corticosteroids, it is possible to perform a pharmacodynamic bioassay to obtain acceptable bioequivalence data. In this case, the intensity of the side effect of blanching (vasoconstriction) in the skin caused by topical corticosteroids can be measured. The response is directly proportional to the clinical efficacy, and the skin blanching assay has proved to be a reliable procedure for the determination of topical corticosteroid bioavailability. Recently, we had sight of the results of a topical bioequivalence study, which was conducted for the registration of a new generic corticosteroid cream formulation. In this trial the new formulation was compared to two equivalent product from the local market and bioequivalence was demonstrated by the investigators for all three products. These results were examined with interest as the respective reference products have been used repeatedly as standard formulations in our laboratory. However, one of these reference formulations has consistently shown superior bioavailability in our trials, but was not demonstrated to be superior in the study results examined. In the present publication an overview of topical bioequivalence testing in general is given and the difficulties occurring in practice, for topical corticosteroid formulations in particular, are demonstrated.
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Chromametry: measuring precision of diurnal and local variation of human forearm skin colour
- Authors: Schwarb, Fabian P , Smith, Eric W , Haigh, John M , Surber, Christian
- Date: 1998
- Language: English
- Type: Conference paper
- Identifier: vital:6343 , http://hdl.handle.net/10962/d1006610
- Description: Chromameters are compact portable instruments used for the assessment of surface colour based on the tristimulus analysis of a reflected xenon light pulse, and have been used for the quantification of erythema in the study of irritant dermatitis, and corticosteroid-induced skin blanching in the vasoconstriction assay. The variability and the reproducibility of chromameter results were investigated since it is known that the location and application force of the measuring head on the skin and the orthostatic maneuver of the arms influence the colour measurement. Furthermore the diurnal variation and the homogeneity of forearm skin colour were investigated.
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Comparison of visual CR-200 and CR-300 chromameter data obtained from the corticosteroid-induced skin-blanching assay
- Authors: Schwarb, Fabian P , Smith, Eric W , Haigh, John M , Surber, Christian
- Date: 1998
- Language: English
- Type: Conference paper , text
- Identifier: vital:6344 , http://hdl.handle.net/10962/d1006611
- Description: In a recent Guidance document the American FDA recommended the use of a chromameterrather thanthe human eye for the assessment of the pharmacodynamic blanching response produced after topical application of corticosteroids. The purpose of this study was to investigate the appropriateness of the human eye and two types of chromameter for the estimation of skin blanching.
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Evaluation of the proposed FDA pilot-dose response methodology for topical corticosteroid bioeqivalence testing [authors' reply in Letters to the Editor]
- Authors: Smith, Eric W , Walker, Roderick B , Haigh, John M , Kanfer, Isadore
- Date: 1998
- Language: English
- Type: text , Article
- Identifier: vital:6423 , http://hdl.handle.net/10962/d1006558
- Description: Reply to: Letter to the Editor by Singh GJ; Fleischer N; Lesko L; Williams R - relating to original article in Pharmaceutical Research (USA), Mar 1997, vol. 14, pp. 303-308.
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New developments in the methodology available for the assessment of topical corticosteroid-induced skin blanching
- Authors: Haigh, John M , Smith, Eric W , Maibach, Howard I
- Date: 1998
- Language: English
- Type: text , Article
- Identifier: vital:6384 , http://hdl.handle.net/10962/d1006305
- Description: Since the publication of the previous edition of this book there have been considerable developments and controversy in the field of topical corticosteroid bioequivalence assessment. There has been considerable discussion in the literature concerning the use of the Minolta chromameter for the measurement of corticosteroid-induced skin blanching, as it is believed this instrument would produce more objective results than the visual grading procedure. These efforts culminated in the release of a guidance document from the Food and Drug Administration (FDA) detailing the procedures to be followed for the determination of topical corticosteroid bioequivalence using the chromameter. Since the promulgation of this document there have been challenges on the validity and scientific merit of the documented procedures, and recently the FDA itself conceded that it may be necessary to redefine some of the protocol evaluations. This chapter attempts to redefine the current standing of the two methods of response assessment.
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Precision of tristimulus chromameter results from corticosteroid-induced skin blanching
- Authors: Smith, Eric W , Haigh, John M
- Date: 1998
- Language: English
- Type: Conference paper
- Identifier: vital:6342 , http://hdl.handle.net/10962/d1006609
- Description: The human skin blanching (vasoconstriction) assay has been in use for 3 decades as a tool for the assessment of the release of corticosteroids from topical dosage forms. Application of corticosteroids produces a whitening (blanching) of the skin, the intensity of which is directly related to the clinical efficacyof the formulation. Assessment of the intensity of the induced blanching has classically been, and continues to be, pe1fonned by visual grading, a method which has been criticised because of the subjectivenature of the assessment Recently there has been considerablediscussion in the literature regarding the use of the chromameter as an objective instrumental method of monitoring corticosteroid induced skin blanching for bioequivalence assessment purposes. The FDA has released a Guidance document recommending the use of the chromameter for this purpose. The chromameter measures colour in teims of three indices: the L-scale (light-dark), the a-scale (red-green) and the b-scale (yellow-blue).Any colour can be expressedabsolutelyin terms of these three values.The Guidance protocol suggests the use of only the a-scale values in quantifying the blanching response after correction of the data which includes subtraction of baseline and unmedicated site values. One of the unresolved issues in the FDA Guidance document is this method of data manipulation suggested since the instrument should be capable of assigning an absolute colour value to each site during the vasoconstriction period. The purpose of this study was to manipulate the instrumental data from a typical blanching study in a number of ways to investigate the appropriatenessof these suggested procedures.
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The requirements for accurate analysis of pharmaceutical research at South African Universities
- Authors: Haigh, John M , Smith, Eric W
- Date: 1998
- Language: English
- Type: text , Article
- Identifier: vital:6367 , http://hdl.handle.net/10962/d1006067
- Description: International Pharmaceutical Abstracts is a valuable database for pharmaceutical research, although the multisiciplinary nature of this field implies that the database should only be the starting point of a search. This database is totally inappropriate for comparing outputs of individual pharmacy teaching institutions.
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The use of supersaturated solutions for the percutaneous delivery of rooperol tetra-acetate
- Authors: Pefile, S C , Haigh, John M , Smith, Eric W
- Date: 1998
- Language: English
- Type: Conference paper , text
- Identifier: vital:6340 , http://hdl.handle.net/10962/d1006537
- Description: A major problem encountered in the transdermal delivery of drugs is the effectiveness of the barrier system imposed by the stratum corneum.To overcome tbe resistance of the skin to the ingress of exogenous chemicals, numerous innovative techniques requiring complex delivery systems have been studied. Many of these systems attempt to alter the barrier potential by the use of enhancer technology. Supersaturation, on the other hand, is a simple and economical technique which is not intended to modify the physical structure or the chemical composition of the stratum corneum, yet may effectively deliver a markedly greater mass of drug to the skin than that achieved by the use of conventional, saturated solutions. Supersaturated systems make use of the elevated thermodynamic activity of the permeant in the delivery vehicle, which results in higher flux rates across the contacting membrane by increasing the concentration gradient. The present study investigated the potential for using supersaturation techniques to transdermally deliver rooperol tetra-acetate (RTA), a lipophilic, cytotoxic agent with potential for use in the treatment of solar keratosis. The diffusion characteristics of the drug from a 60% propylene glycol/water supersaturated solution across silicone membrane and full thickness rat skin were studied using Franz diffusion cells. A comparison was made of the drug diffusion rates from a saturated system and from supersaturated systems prepared with and without an antinucleating agent.
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Evaluation of the proposed FDA pilot-dose response methodology for topical corticosteroid bioequivalence testing
- Authors: Demana, Patrick H , Smith, Eric W , Walker, Roderick B , Haigh, John M , Kanfer, Isadore
- Date: 1997
- Language: English
- Type: Article
- Identifier: vital:6356 , http://hdl.handle.net/10962/d1006047
- Description: The American FDA has recently released a Guidance document for topical corticosteroid bioequivalence testing. The purpose of this study was to evaluate the recommendations of this document for appropriateness. The new specifications require a dose-vasoconstriction response estimation by the use of a Minolta chromameter in a preliminary pilot study to determine the parameters for use in a pivotal bioequivalence study. Methods. The visually-assessed human skin blanching assay methodology routinely practiced in our laboratories was modified to comply with the requirements of the pilot study so that visual and chromameter data could be compared. Two different cream formulations, each containing 0.12% betamethasone 17-valerate, were used for this comparison. Results. Visual data showed the expected rank order of AUC values for most dose durations whereas the chromameter data did not show similar results. The expected rank order of AUC values for both chromameter and visual data was not observed at very short dose durations. In fitting the data to pharmacodynamic models, equivalent goodness of fit criteria were obtained when several different parameter estimates were used in the model definition, however the visual data were best described by the sigmoid E[subscript max] model while the chromameter data were best described by the simple E[subscript max] model. Conclusions. The E[subscript max] values predicted by the models were close to the observed values for both data sets and, in addition, excellent correlation between the AUC values and the maximum blanching response (R[subscript max]) (r > 0.95) was noted for both methods of assessment. The chromameter ED[subscript 50] values determined in this study were approximately 2 hours for both preparations. At this dose duration the instrument would not be sensitive enough to distinguish between weak blanching responses and normal skin for bioequivalence assessment purposes.
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The human skin blanching assay for in vivo topical corticosteroid assessment. II. Subject- and observer-dependent variation in blanching responses
- Authors: Haigh, John M , Meyer, Eric , Smith, Eric W , Kanfer, Isadore
- Date: 1997
- Language: English
- Type: text , Article
- Identifier: vital:6382 , http://hdl.handle.net/10962/d1006300
- Description: The human skin blanching (vasoconstriction) assay for the assessment of topical corticosteroids has been in use for over 30 years, the intensity of the drug-induced blanching being assessed subjectively by eye. Both arms of several male and female volunteers are used for product application and more than one observer is used to estimate the degree of induced blanching. There are, therefore, numerous variables which are inherent in the assay procedure. This investigation consisted of three identical trials performed at 8-week intervals, utilising the same 18 volunteers and the same three observers in an attempt to address the question of reproducibility of the assay. From the results obtained it is clear that the assay methodology is capable of consistently distinguishing, on a rank order basis, between preparations which show similar blanching (chemically-equivalent formulations). The similarity of the results for the three individual trials gives considerable confidence to results produced using this methodology. An experiment designed to test the reproducibility of the blanching scores showed that the observers are capable of producing identical results even though visual observation is highly subjective.
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The human skin-blanching assay for in vitro topical corticosteroid assessment. I. Reproducibility of the assay
- Authors: Haigh, John M , Meyer, Eric , Smith, Eric W , Kanfer, Isadore
- Date: 1997
- Language: English
- Type: text , Article
- Identifier: vital:6381 , http://hdl.handle.net/10962/d1006299
- Description: The human skin blanching (vasoconstriction) assay for the assessment of topical corticosteroids has been in use for over 30 years, the intensity of the drug-induced blanching being assessed subjectively by eye. Both arms of several male and female volunteers are used for product application and more than one observer is used to estimate the degree of induced blanching. There are, therefore, numerous variables which are inherent in the assay procedure. This investigation consisted of three identical trials performed at 8-week intervals, utilising the same 18 volunteers and the same three observers in an attempt to address the question of reproducibility of the assay. From the results obtained it is clear that the assay methodology is capable of consistently distinguishing, on a rank order basis, between preparations which show similar blanching (chemically-equivalent formulations). The similarity of the results for the three individual trials gives considerable confidence to results produced using this methodology. An experiment designed to test the reproducibility of the blanching scores showed that the observers are capable of producing identical results even though visual observation is highly subjective.
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Role of percutaneous penetration enhancers
- Authors: Walker, Roderick B , Smith, Eric W
- Date: 1996
- Language: English
- Type: text , Article
- Identifier: vital:6446 , http://hdl.handle.net/10962/d1006633
- Description: It is clear that scientists are now only beginning to comprehend the complexity of transdermal drug delivery. Elucidation of the biochemical composition and functioning of the intrinsic diffusional barrier of the stratum corneum has prompted investigation of chemical and physical means of enhancing the percutaneous penetration of poorly absorbed drugs. Chemical enhancers that aid absorption of co-administered moieties are currently believed to improve solubility within the stratum corneum or increase lipid fluidity of the intracellular bilayers. Alternatively,the use of ionto- or phonophoresis may facilitate the absorption of some drug molecules by physical alteration of the barrier. The role of penetration enhancer inclusion in topical formulations has been well documented and will undoubtedly, in the future, permit the delivery of broader classes of drugs through the stratum corneum.
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Assessing penetration enhances for topical corticosteroids
- Authors: Smith, Eric W , Haigh, John M
- Date: 1995
- Language: English
- Type: Book chapter
- Identifier: vital:6442 , http://hdl.handle.net/10962/d1006629
- Description: From introduction: Topical corticosteroids have been used for a wide range of dermatological conditions for the last 4 decades. For many years the topical delivery system was a relatively simple cream or ointment base, with little thought given to improving the formulation as far as drug delivery was concerned. The main emphasis in the initial stages of development was on the alteration of the corticosteroid molecule, in an attempt to produce moieties with a higher intrinsic topical effect with lower mineralocorticoid side effects. Once this avenue of research was exhausted, attention was placed on the lipophilicity of the molecule with the production of various types of esters in an attempt to produce molecules which would pass through the stratum corneum (SC) with reasonable ease. In recent years the nature of the semisolid drug delivery base has received considerable attention.2-5The nature of the vehicle has a profound effect on the rate of release of the topical corticosteroid from the formulation and its passage through the SC. One of the most important aspects of the formulation of the base is the inclusion of substances which aid this trads-SC diffusion, the so-called penetration enhancers.6The modes of action of the various different types of penetration enhancers are reviewed elsewhere in this book. The best method for the assessment of the release of corticosteroids from topical formulations is obviously the clinical tri~. Clinical trials, however, are laborious, costly, and difficult to mount. Patients suffering from dermatological complaints are not ideal subjects for the testing of topical corticosteroid formulations as it is difficult to obtain standardized lesions which are necessary for the comparison of results between formulations. Alternatively, a number of in vitro models exist for this type of assessment, but it is often problematic to obtain correlation with the in vivo situation.
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