Invasive
pulmonary aspergillosis is a deadly fungal infection with
a high mortality rate, particularly in patients having undergone transplant
surgery. Voriconazole, a triazole antifungal pharmaceutical product,
is considered as a first-line therapy for invasive pulmonary aspergillosis,
and exhibits efficacy even for patients who have failed other antifungal
drug therapies. The objective of this study is to develop high potency
nanoaggregates of crystalline voriconazole composition for dry powder
inhalation using the particle engineering process, thin film freezing.
In this study, mannitol at low concentrations acted as a surface texture-modifying
agent, and we evaluated the physicochemical and aerodynamic properties
of the voriconazole formulations containing different amounts of mannitol. In vitro aerosol performance data demonstrated that powder
formulations consisting of 90 to 97% (w/w) voriconazole were the optimum
for inhalation with a fine particle fraction (% of delivered dose)
as high as 73.6 ± 3.2% and mass median aerodynamic diameter of
3.03 ± 0.17 μm when delivered by a commercially available
device. The thin film freezing process enabled phase-separated submicron
crystalline mannitol to be oriented such as to modify the surface
texture of the crystalline voriconazole nanoaggregates, thus enhancing
their aerosolization. Addition of as low as 3% (w/w) mannitol significantly
increased the fine particle fraction (% of metered dose) of voriconazole
nanoaggregates when compared to compositions without mannitol (40.8%
vs 24.6%, respectively). The aerosol performance of the voriconazole
nanoaggregates with 5% (w/w) mannitol was maintained for 13 months
at 25 °C/60% RH. Therefore, voriconazole nanoaggregates having
low amounts of surface texture-modifying mannitol made by thin film
freezing are a feasible local treatment option for invasive pulmonary
aspergillosis with high aerosolization efficiency and drug loading
for dry powder inhalation.