Retinal drug delivery is a challenging area in the field of ophthalmic drug delivery. An ideal drug delivery system for the retina and vitreous humor has not yet been found, despite extensive research. Drug delivery to retinal tissue and vitreous via systemic administration is constrained due to the presence of a blood-retinal barrier (BRB) which regulates permeation of substances from blood to the retina. Although intravitreal administration overcomes this barrier, it is associated with several other problems. In recent years, transporter targeted drug delivery has become a clinically significant drug delivery approach for enhancing the bioavailabilities of drug molecules with poor membrane permeability characteristics. Various nutrient transporters, which include peptide, amino acid, folate, monocarboxylic acid transporters and so on, have been reported to be expressed on the retina and BRB. Prodrug derivatisation of drug molecules which target these transporters could result in enhanced ocular bioavailability. Highlighted in this review are various strategies currently employed for drug delivery to the posterior chamber, and novel opportunities that can be exploited to enhance ocular bioavailability of drugs.
Metabolism is one of the primary routes of drug elimination from the body. This process comprises of mechanisms, such as oxidation and conjugation, which lead to inactivation and/or elimination from hepatic, biliary, pulmonary, renal and ocular tissues. Enzymes involved in metabolism are expressed in various tissues of the body, liver being the primary site. Studies involving ocular tissues have demonstrated the expression of several metabolic enzymes such as esterases, peptidases, ketone reductases, and CYP-450's in these tissues. These enzymes play an important role in ocular homeostasis by preventing entry and/or eliminating xenobiotics from the ocular tissues. Scientists have targeted these enzymes in drug design and delivery through prodrug derivatization. The prodrugs undergo biotransformation to the parent drug by ocular enzymatic degradation. This review examines the distribution pattern of various metabolic enzymes in the ocular tissues, their physiological role and utility in targeted prodrug delivery.
IntroductionThere is a need for new therapies in Parkinson’s disease that may help to address known limitations of current options. PF-06649751 is a novel, highly selective dopamine D1/D5 agonist targeted for Parkinson’s disease treatment.MethodsThe safety, pharmacokinetics, and pharmacodynamics of PF-06649751 were assessed in single ascending dose and multiple ascending dose clinical trials in patients with Parkinson’s disease. The single ascending dose study (N = 18) was a double-blind, placebo-controlled study with a three-way crossover design consisting of three treatment periods separated by 7-day study drug washout periods. PF-06649751 doses were 0.75 mg, 1.5 mg, 3 mg, 6 mg, and 9 mg. In the open-label multiple ascending dose study, eligible subjects received once-daily doses of PF-06649751 (N = 45) over 21 days, with up-titration to 5 mg, 15 mg, and 25 mg once daily. Pharmacodynamics were assessed by measuring change from baseline in the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III at different time points post dose.ResultsPF-06649751 was safe and well tolerated across studies and in all cohorts. Peak plasma concentrations were attained 1–4 h post dose across both studies, and exposure increased with increasing dose. PF-06649751 demonstrated sustained pharmacodynamic effects compared with placebo, with mean reductions from baseline in the MDS-UPDRS Part III up to 12 h post dose at 9 mg single dose. MDS-UPDRS Part III changes in the open-label multiple dose study on day 22 also demonstrated sustained pharmacodynamic activity.ConclusionsPF-06649751 represents a novel therapeutic candidate for Parkinson’s disease with an initial safety, tolerability, and pharmacokinetic profile and potential for efficacy that merits further study in larger clinical trials.Trial registrationThese studies are registered at www.clinicaltrials.gov as NCT02373072, NCT02224664.FundingPfizer.Electronic supplementary materialThe online version of this article (10.1007/s40120-018-0114-z) contains supplementary material, which is available to authorized users.
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