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Drugs and Therapeutics
Published in James Sherifi, General Practice Under the NHS, 2023
In 2003, the BMJ published a paper that first coined the term ‘polypill,’39 a single pill that combined a low dose of aspirin, statin, and antihypertensives, all agents still well represented in the list of commonly prescribed drugs above. The author made a compelling case that 80% of cardiovascular disease would be prevented if the UK adult population took the daily pill; a cost-effective, cheap, and safe strategy for the health of the nation. The conclusions of the article were so compelling that the Lancet was still promoting the benefits, never implemented, some 18 years later!40
Three-Dimensional Printing: Future of Pharmaceutical Industry
Published in Harishkumar Madhyastha, Durgesh Nandini Chauhan, Nanopharmaceuticals in Regenerative Medicine, 2022
Manju Bala, Anju Dhiman, Harish Dureja, Munish Garg, Pooja A Chawla, Viney Chawla
Khaled et al developed polypill of five in one by 3D hot melt extrusion printing. The pharmaceutical active principles used are aspirin with hydrochlorthiazide (immediate release compartment) and atenolol with remipril and pravastatin (sustained release compartment). The evaluation showed that polypill has the ability to deliver each drug in separate manner for the treatment of cardiovascular disorder (Khaled et al. 2015).
Hot topics in medicine
Published in Viyaasan Mahalingasivam, Marc A Gladman, Manoj Ramachandran, Secrets of Success: Getting into Medical School, 2020
Veena Naganathar, Asil Tahir, Pairaw Kader, Omar Chehab
The ‘Polypill’, which has been well covered in the media, is a combination of the above drugs given as one tablet. The Polypill could prove to be a significant advancement in the management of IHD and its risk factors for several reasons. First, it combines five drugs into one pill, which will make it much more convenient for patients and will increase adherence to medication. Second, if given at a younger age to people who do not have symptoms, their risk of developing cardiovascular disease may be reduced in the long term. Finally, the five drugs that make the Polypill are cheap and therefore this represents a potentially cost-effective measure of preventing heart disease. It is currently undergoing clinical trials, although, as the component ingredients are off patent, pharmaceutical companies are showing little interest in the drug, because it does not have as great a profit margin as individual drugs.
Classes of drugs that target the cellular components of inflammation under clinical development for COPD
Published in Expert Review of Clinical Pharmacology, 2021
Maria Gabriella Matera, Luigino Calzetta, Rosa Annibale, Francesco Russo, Mario Cazzola
Most patients with COPD have concomitant chronic diseases, such as cardiovascular disease and diabetes mellitus type 2 [147]. Many of these comorbidities have been related to the presence of a systemic inflammation but inhaled anti-inflammatory drugs have the potential to reduce pulmonary inflammation while having low systemic exposure [148]. There is therefore a need to focus on how better targeting both systemic and pulmonary inflammation in COPD. This is the reason why COPD and its comorbidities should always to be considered in an integrated way [149,150], which means a quite complicated therapy. However, adherence to medication is low in patients suffering from several pathologies and decreases with each additional tablet [151]. A strategy based on the use of a fixed-dose combination or polypill, including key medications for COPD and its comorbidities, which means also anti-inflammatory molecules, has the potential to target both pathologies simplifying healthcare delivery, improving cost-effectiveness, increasing medication adherence, and supporting a comprehensive prescription of evidence-based therapies [152]. However at present the development of the polypill approach seems to be mainly focused on cardiovascular disease.
Embracing the polypill as a cardiovascular therapeutic: is this the best strategy?
Published in Expert Opinion on Pharmacotherapy, 2018
Beata Franczyk, Anna Gluba-Brzózka, Łukasz Jurkiewicz, Peter Penson, Maciej Banach, Jacek Rysz
The concept of the ‘polypill’ for the reduction of cardiovascular risk was proposed by Wald and Law [5] in 2000. A polypill is a fixed combination of drugs in a single tablet or capsule. The initial polypill consisted of three different classes of antihypertensive drugs (each at half dose), in addition to aspirin, a statin, and folic acid. The challenge today is to produce polypills containing drugs with complementary actions and established efficacy in the reduction of modifiable risk factors for CVD [3].
3D printing for enhanced drug delivery: current state-of-the-art and challenges
Published in Drug Development and Industrial Pharmacy, 2020
Melissa Wallis, Zaisam Al-Dulimi, Deck Khong Tan, Mohammed Maniruzzaman, Ali Nokhodchi
Despite associated challenges which have made the commercial exploitation of 3D printing in the pharmaceutical sphere limited, 3D printing has been used in a variety of applications in medicine to date, mainly due to the availability of several materials and methods. These include applications in biomedicine, but also applications to produce different dosage forms such as tablets, capsules, oro-dispersible films, microneedles and more (Table 1). While conventional methods such as direct compression of tablets, capsules, and film casting are cost-effective for large-scale production, innovative 3D printing technology provides flexibility and free-form geometries to be created. This opposes the conventional technology which is dosage-inflexible, intensive in labor and time-consuming [29]. Emerging 3D printing also shifts the current practice of producing medicine from a ‘one-size-fits-all’ manner, toward patient-specific delivery or personalization. Personalized medicine integrates the pharmacogenetic profiles and pharmacokinetic characteristics of patients individually or in a subgroup with clinical tools and treatments that will consider their genetic variation to develop therapies that are suitable for their conditions, whilst reducing adverse drug-reactions and delivering more efficient treatments [30]. Researching pharmacogenetics allows researchers to gain an understanding of DNA variations that cause particular reactions to particular drugs [31]. With this approach, the pharmaceutical field was encouraged and consequently fashioned to tailoring personalized therapies to patients by taking their genetic profiles into account. Although there is no specific example of 3D printing applications integrating actual pharmacogenetic and DNA variation profiles from the patient, some early studies on i.e. fixed-dose combinations or integration of multiple drugs in one advanced pill showed some promise. An example of this is creating multi-active solid dosage forms that contain a few different active pharmaceutical ingredients (APIs). Khaled et al. designed a dosage form containing nifedipine, captopril, and glipizide each separated in different compartments and possessing different release profiles. This compartmentalization technique was also adapted in other ways, such as the polypill created by the same research group. The polypill was a single tablet that contained five drugs, also with different release profiles [22]. 3D printing brings this adjustability and thus is especially beneficial for patients that are on several medications.