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. 2019 Mar;35(2):124-131.
doi: 10.1089/jop.2018.0096. Epub 2019 Jan 7.

Co-Delivery of Timolol and Brimonidine with a Polymer Thin-Film Intraocular Device

Affiliations

Co-Delivery of Timolol and Brimonidine with a Polymer Thin-Film Intraocular Device

Karen E Samy et al. J Ocul Pharmacol Ther. 2019 Mar.

Abstract

Purpose: We developed a polycaprolactone (PCL) co-delivery implant that achieves zero-order release of 2 ocular hypotensive agents, timolol maleate and brimonidine tartrate. We also demonstrate intraocular pressure (IOP)-lowering effects of the implant for 3 months in vivo.

Methods: Two PCL thin-film compartments were attached to form a V-shaped co-delivery device using film thicknesses of ∼40 and 20 μm for timolol and brimonidine compartments, respectively. In vitro release kinetics were measured in pH- and temperature-controlled fluid chambers. Empty or drug-loaded devices were implanted intracamerally in normotensive rabbits for up to 13 weeks with weekly measurements of IOP. For ocular concentrations, rabbits were euthanized at 4, 8, or 13 weeks, aqueous fluid was collected, and ocular tissues were dissected. Drug concentrations were measured by liquid chromatography-tandem mass spectrometry.

Results: In vitro studies show zero-order release kinetics for both timolol (1.75 μg/day) and brimonidine (0.48 μg/day) for up to 60 days. In rabbit eyes, the device achieved an average aqueous fluid concentration of 98.1 ± 68.3 ng/mL for timolol and 5.5 ± 3.6 ng/mL for brimonidine. Over 13 weeks, the drug-loaded co-delivery device resulted in a statistically significant cumulative reduction in IOP compared to untreated eyes (P < 0.05) and empty-device eyes (P < 0.05).

Conclusions: The co-delivery device demonstrated a zero-order release profile in vitro for 2 hypotensive agents over 60 days. In vivo, the device led to significant cumulative IOP reduction of 3.4 ± 1.6 mmHg over 13 weeks. Acceptable ocular tolerance was seen, and systemic drug levels were unmeasurable.

Keywords: brimonidine; co-delivery; controlled release; drug delivery systems; glaucoma; timolol.

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Conflict of interest statement

T.A.D. is a co-founder of Zordera and is on the advisory board for Santen; R.B.B. receives a research grant from Genentech, receives consulting fees from Ribomic, Inc. and AntriaBio, is a co-founder of Zordera, is on the advisory board for Santen, and is on the advisory board for Sandoz, Biotime, and Quark. The remaining authors have no conflict of interests.

Figures

<b>FIG. 1.</b>
FIG. 1.
Schematic diagram of 2-compartment device fabrication (A). To make each compartment, spun-cast PCL thin films were heat sealed along the edges (I), shown as dotted lines, and filled with either timolol maleate (orange) or brimonidine tartrate (green) (II). The drug-loaded compartments were sealed closed (III) and the 2 compartments were attached at a sealed edge (IV). Each compartment is about 2 mm in width by 4 mm in length. The attached device is shown with grains of rice for scale (B). PCL, polycaprolactone. Color images available online at www.liebertpub.com/jop
<b>FIG. 2.</b>
FIG. 2.
Cumulative drug release (A, B) and release rates (C, D) of timolol maleate (A, C) and brimonidine tartrate (B, D). Linear regression fit of cumulative drug release versus time demonstrated zero-order release for both timolol and brimonidine. Mean ± standard deviation (n = 3 for A, C, n ≥ 3 for B, D).
<b>FIG. 3.</b>
FIG. 3.
Representative photos of rabbit eyes immediately after implantation (left column) and before sacrifice (right column) of empty or drug-loaded co-delivery devices in the anterior chamber of the OS eyes. OS, oculus sinister. Color images available online at www.liebertpub.com/jop
<b>FIG. 4.</b>
FIG. 4.
Concentrations of timolol maleate (A) and brimonidine tartrate (B) in relevant ocular tissues after 4, 8, and 13 weeks of device implantation and concentrations in the aqueous humor (C) and the ICB (D) of both drugs. Mean ± standard deviation (n = 4). ICB, iris-ciliary body.
<b>FIG. 5.</b>
FIG. 5.
Mean ± standard deviation (n = 4) of IOP change from baseline for drug-loaded eyes (A) and empty device eyes (B) compared to their contralateral control eyes over 91 days. IOP, intraocular pressure. Color images available online at www.liebertpub.com/jop
<b>FIG. 6.</b>
FIG. 6.
Cumulative IOP reduction represented as the AUC of baseline-subtracted IOP values of drug-loaded device-treated eyes (n = 4), empty device-treated eyes (n = 4), and their contralateral control eyes (n = 8) over 91 days. (*p < 0.05; **p < 0.01) Mean ± standard deviation. AUC, area under the curve.
<b>FIG. 7.</b>
FIG. 7.
Histological images of the rabbit normal cornea (A) and normal angle (B) in the anterior segment of the OS eye. Images of the anterior segment showing examples of corneal neovascularization (C), fibrous metaplasia shown by thickening of the endothelium (D), iris synechia (E), and lymphocytes in the posterior stroma signaling focal inflammation (F). Color images available online at www.liebertpub.com/jop

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