Zoladex; A Case Study Flashcards

1
Q

What is the formulation problem regarding the treatment of prostate cancer?

A

Requires a sustained release of a peptide therapeutic:

  • How to get a sustained release profile? (polymer implant)
  • What kind of polymer can encapsulate a drug and release it over time?
  • What are the formulation requirements of the drug? (LHRH; luteinizing hormone-releasing hormone agonists)
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2
Q

How does goserelin work? What is it used to treat?

A
  • Decapeptide agonist of LHRH
  • Initial exposure to goserelin increases release of testosterone or oestrogen
  • Long-term exposure blocks testosterone/oestrogen release; results in chemical castration due to desensitisation
  • Treats prostate cancer
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3
Q

What formulation obstacles do goserelin pose?

A
  • Has a 2 hour half-life
  • Is a peptide; requires injection
  • How to dose patient chronically w/o daily injections? (unpleasant/painful)
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4
Q

What are the different ways of achieving slow drug dissolution?

A
  • High molecular weight water-soluble polymer
    • Dense and entangled
    • Disentangling gel
    • Polymer solid
    • Polymer chain in solution
    »> Water infiltrates, polymer chain unfolds, releasing drug
  • Chemical breakdown of the polymer
    • Dense and entangled
    • Chain scission of polymer chain into smaller fragments
    • Dissolution of low molecular weight products
    • Soluble fragments
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5
Q

What are the problems with achieving slow drug dissolution from a high molecular weight water-soluble polymer/chemically broken down polymer?

A
  • Unreliable as dependent on entanglement
  • Most polymers dissolve quicker than required for goserelin release
  • Poor renal excretion of high molecular weight polymer; don’t want polymer to keep circulating
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6
Q

How do we achieve a polymer that slowly breaks down in the body? (required for goserelin slow-release)

A
  • Need a chemical group that hydrolyses (water infiltration to break down polymer chain)
  • Anhydrides/Orthoesters/Esters/Peptides (slowest)
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7
Q

What polymer is chosen as a result for slow breakdown in the body to deliver LHRH? What are the requirements of this polymer?

A
  • Polymer must be insoluble
  • BUT, low molecular weight degradation products must be water-soluble
    »> Polyester
    • Water insoluble w/high molar mass; achieved by making v. long polyester chains
    • Monomer unit at the end is water-soluble
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8
Q

How does poly(lactic acid) polymerise?

A
  • Polymerised from dimer; lactide

- L, L-Lactide and D, L-Lactide (two chiral centres)

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9
Q

What is the effect of stereochemistry on poly(lactic acid) degradation?

A
  • Poly(DL-lactic acid) takes 1 year to fully degrade
  • Poly(L-lactic acid) takes more than 2 years to fully degrade
Explained by crystallinity: 
• Poly(DL-lactic acid); amorphous
- Lower density
- Loosely packed chains (can't pack as well)
- More rapid water penetration
- Faster hydrolysis

• Poly(L-lactic acid); semi-crystalline

  • Dense
  • Low water penetration (due to crystalline structure)
  • Slow hydrolysis (hence > 2 years to hydrolyse)
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10
Q

What is the difference between degradation and erosion?

A

Degradation:
- Chemical breakdown of polymer chains (into monomer units etc.)

Erosion:

  • When polymer chains have decreased in MW sufficiently
  • Creating enough hydrophilic end groups to drive water solubility (low MW degradation products)
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11
Q

What is bulk erosion? What polymer undergoes it?

A
  • Don’t need complete breakdown of polymer for drug release
  • Water penetration and chain scission more rapid than erosion
  • Drug release occurs faster than polymer erosion; some drug can escape when the polymer hydrates (plasticises)
  • Degradation, THEN erosion
    E.g. poly(lactic acid)
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12
Q

What is the effect of adding glycolic acid to the polylactic acid polymer making a co-polymer?

A
  • Adding glycolic acid (monomer) to PLA forms PLGA; poly(lactic acid-co-glycolic acid)
  • The GA component is more susceptible to hydrolysis; lacks a hydrophobic, oily protecting methyl side-chain (which would normally hinder H2O ingress)
  • Thus increasing GA content in PLGA speeds up degradation time in the patient; faster release of drug
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13
Q

Why does PLGA 50:50 not follow predicted degradation kinetics of decreasing PGA (poly(glycolic acid)) content?

A
  • PLGA 50:50 degrades faster than PGA 100 as the respective chains do not pack together as well/uniformly; not just about hydrophobicity
  • PGA 100 homo-polymer degrades as its chains can pack together nicely (compensating for lack of protecting methyl group)
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14
Q

What is the effect of autocatalysis on polymer degradation (hydrolysis), and how can this be rectified?

A
  • COOH and COH generated from polyester degradation
  • Introduces more H+; local acidity enhances hydrolysis rate (H+ can’t diffuse away/escape)
  • Build-up of H+ in the middle of the device; THUS long thin rods are used to house the polymer-drug rather than a large bulk
    »> Peptides (LHRH, the drug goserelin) are acid-labile (will produce H+) too as well as esters
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15
Q

How does the Astrazeneca preparation Zoladex compare with its sister Zoladex LA?

A

Zoladex:

  • 1 month depot system (shorter)
  • 3.6mg goserelin (lower strength)
  • PLGA; 50% DL-lactic acid, 50% glycolic acid
  • Mix of high and low MW drugs to fine tune controlled release; does not require as much degradation before drug release
  • Cylindrical rod of 11 x 1.1 mm (shorter and smaller)
  • SC injection

Zoladex LA:

  • 3 month depot system
  • 10.8mg goserelin
  • PLGA 95:5 (a lot more of the hydrophobic DL-lactic acid; only 5% glycolic acid)
  • Mix of high and low MW drugs to fine tune controlled release
  • Rod of 18 x 1.5 mm
  • SC injection (rapid dispersion from SC site when drug escapes)
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16
Q

What are Zoladex/Zoladex LA release rates like in practice?

A
  • Dosing more rapid than predicted from polymer degradation alone; autocatalytic degradation is still pronounced in rod systems
  • There is increased local acidity as lactic acid oligomers cannot escape
  • But hydration and fragmentation of the rod allows drug release by diffusion mechanism before full diffusion of polymer
  • Low MW chains increase early erosion
  • Plasticisation by lower molar mass components
17
Q

How does the pH within PLGA polymers of goserelin change over time?

A
  • Acid is seen to be able to diffuse away from the surface/outside of the polymer, but then is stuck in the middle
  • Due to autocatalysis (pH is lower in the middle)