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Immunotherapy 2014Allergen immunotherapy is a disease-modifying therapy, effective for the treatment of allergic rhinitis, allergic asthma, conjunctivitis or stinging insect allergy.... (Review)
Review
Allergen immunotherapy is a disease-modifying therapy, effective for the treatment of allergic rhinitis, allergic asthma, conjunctivitis or stinging insect allergy. Allergen immunotherapy involves the administration of increasing doses of allergens with the aim of ameliorating the allergic response. Although precise underlying mechanisms of the induction of immune tolerance remain unclear, immunotherapy has been associated with the induction of distinct subsets of Tregs that eventually lead to peripheral tolerance by inducing a deviation from Th2 to Th1 immune responses. This review focuses on the current knowledge of the mechanisms of immunotherapy in relationship to different routes of administration and also provides a unifying view.
Topics: Allergens; Cytokines; Desensitization, Immunologic; Drug Administration Routes; Humans; Hypersensitivity; Immune Tolerance; Models, Immunological; Signal Transduction
PubMed: 25186606
DOI: 10.2217/imt.14.47 -
Nephrology Nursing Journal : Journal of... 2007Several clinical studies have indicated that compared with intravenous (IV) administration, subcutaneous (SC) administration of Epoetin alfa may result in a dose-sparing... (Review)
Review
Several clinical studies have indicated that compared with intravenous (IV) administration, subcutaneous (SC) administration of Epoetin alfa may result in a dose-sparing effect in patients on hemodialysis. However, data also indicate wide inter-patient variability in response, with many patients requiring the same or a higher dose following conversion to SC administration. Convenience favors IV administration of Epoetin alfa in patients on hemodialysis, and patient preferences and comfort should also be primary considerations. For patients who prefer SC injections, the nurse's coordination of the required dosing, administration, and operational factors is key to maintaining and improving anemia-related outcomes.
Topics: Anemia; Choice Behavior; Clinical Nursing Research; Drug Administration Routes; Drug Administration Schedule; Drug Monitoring; Epoetin Alfa; Erythropoietin; Hematinics; Humans; Infusions, Intravenous; Injections, Subcutaneous; Kidney Failure, Chronic; Nursing Assessment; Patient Participation; Patient Selection; Recombinant Proteins; Renal Dialysis; Research Design; Treatment Outcome
PubMed: 18041455
DOI: No ID Found -
European Journal of Pharmaceutics and... Oct 2014The local administration of antibodies can represent in many cases a significant improvement for antibody-based therapies. The benefits of local delivery include high... (Review)
Review
The local administration of antibodies can represent in many cases a significant improvement for antibody-based therapies. The benefits of local delivery include high drug concentrations at the target site, the possibility of lower drug dosing and less systemic drug exposure. Currently, the most relevant delivery sites for therapeutic antibodies are the posterior segments of the eye, mucosal surfaces, the articular joints and the central nervous system (CNS). In addition, the oral and pulmonary route may enable non-invasive systemic antibody delivery. However, local antibody delivery to these sites is characterized by short drug residence times and a low compliance of administration. Controlled release (CR) systems can address these limitations and, thereby, enable and improve local delivery applications by achieving long lasting local drug concentrations, improved efficacy-dosing ratios and reduced treatment-associated side effects. The requirements for CR antibody formulations are more complex compared to conventional CR systems for small molecules, and their development poses an enormous technical challenge. Therefore, the review highlights experiences and challenges gathered in the development of the different CR systems for antibodies to date. Additionally, the unmet technological needs encountered in the field are described. This includes a critical evaluation of the limited capability of various CR systems to preserve antibody stability, delivery site specific considerations, as well as the processability of a CR system with a particular focus on drug loading and injectability. We believe that the success of CR and local delivery approaches could create an enormous added value for patients in the future.
Topics: Animals; Antibodies; Drug Administration Routes; Drug Delivery Systems; Humans; Pharmacokinetics
PubMed: 25125350
DOI: 10.1016/j.ejpb.2014.08.001 -
Immunology and Allergy Clinics of North... Nov 2008The availability of IgG preparations that could be administered safely by the intravenous route was finally achieved in the early to mid-1980s. Intravenous... (Review)
Review
The availability of IgG preparations that could be administered safely by the intravenous route was finally achieved in the early to mid-1980s. Intravenous immunoglobulin (IVIG) revolutionized the treatment of primary immune deficiency diseases (PIDD) and led to the discovery of the therapeutic value of high-dose IgG in autoimmune and inflammatory diseases not associated with PIDD. Improved therapy has improved outcomes and expectations, and most PIDD patients can lead fully active and productive lives. Administration of IgG by the subcutaneous route is effective and safe and overcomes obstacles to the use of IVIG in some patients. Many patients find administration of subcutaneous IgG at home more convenient than receiving IVIG at the Doctor's office or hospital. The coming years will see increased use of subcutaneous immunoglobulin in PIDD, which will be facilitated by advances leading to higher-concentration IgG products and easier delivery.
Topics: Animals; Clinical Protocols; Clinical Trials as Topic; Drug Administration Routes; Drug Approval; Drug Costs; Female; Humans; Immunoglobulins, Intravenous; Immunologic Deficiency Syndromes; Injections, Subcutaneous; Pregnancy; Pregnancy Complications; Quality of Life; Treatment Outcome
PubMed: 18940574
DOI: 10.1016/j.iac.2008.07.002 -
Route transition interventions: potential public health gains from reducing or preventing injecting.The International Journal on Drug Policy Mar 2010Multiple factors are implicated in the diffusion of injecting drug use (IDU), including individual and demographic characteristics, drug markets, economics, social... (Review)
Review
Multiple factors are implicated in the diffusion of injecting drug use (IDU), including individual and demographic characteristics, drug markets, economics, social networks and political and cultural environments. However, studies show that individual transitions away from injecting are possible, and that a recent diffusion of non-injecting routes of administration (NIROA) has occurred in several countries. Injecting is more risk-laden than other routes of drug administration, yet relatively little attention has been paid to reducing or preventing injecting drug use by promoting NIROA. This commentary reviews the case for, and examples of, 'route transition interventions' which seek to do this. These include: prescribing oral substitutes; providing non-injecting equipment; providing safer smoking facilities; and training individuals to prevent transitions to injecting, promote NIROA, or prevent the initiation of new injectors. These initiatives have the potential-as yet largely unrealised-to offer public health gains and empower people to control and manage their drug use. Further research is needed to secure commitments at all levels to support this approach.
Topics: Disease Outbreaks; Drug Administration Routes; Harm Reduction; Humans; Injections, Intravenous; Preventive Health Services; Public Health; Risk Factors; Substance Abuse, Intravenous
PubMed: 20167464
DOI: 10.1016/j.drugpo.2010.01.011 -
Retina (Philadelphia, Pa.) Sep 2014To review the ocular pharmacology and antitumor activity of topotecan for the treatment of retinoblastoma by an evaluation of different routes of administration. (Review)
Review
PURPOSE
To review the ocular pharmacology and antitumor activity of topotecan for the treatment of retinoblastoma by an evaluation of different routes of administration.
METHODS
Systematic review of studies available at PubMed using the keywords retinoblastoma, topotecan, and camptothecins, including preclinical data such as cell lines and animal models, as well as clinical studies in patients with retinoblastoma.
RESULTS
Forty-two available studies were reviewed. Evidence of antitumor activity against retinoblastoma as a single agent is based on data on cell lines and a limited number of affected patients with intraocular and extraocular disease when given in a protracted schedule. Evidence of additive or synergistic activity in combination with other agents such as carboplatin, melphalan, and vincristine was reported in preclinical and clinical models. In animal models, pharmacokinetic evaluation of topotecan administered by the periocular route shows that most of the drug reaches the vitreous through the systemic circulation. Topotecan administered by intravitreal injection shows high and sustained vitreal concentrations with limited systemic exposure and lack of retinal toxicity at a dose of up to 5 μg. Topotecan administered intraophthalmic artery shows higher passage to the vitreous compared with periocular administration in a swine model.
CONCLUSION
Topotecan alone or in combination is active against retinoblastoma. It shows a favorable passage to the vitreous when given intravenously and intraarterially, and ocular toxicity is minimal by all routes of administration. However, its clinical role, optimal dose, and route of administration for the treatment of retinoblastoma are to be determined.
Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Drug Administration Routes; Humans; Intravitreal Injections; Retinal Neoplasms; Retinoblastoma; Tissue Distribution; Topoisomerase I Inhibitors; Topotecan; Tumor Cells, Cultured; Vitreous Body
PubMed: 25099219
DOI: 10.1097/IAE.0000000000000253 -
European Journal of Hospital Pharmacy :... Dec 2023Voriconazole (VRCZ) is commonly used as oral and intravenous (IV) formulations. Few studies have comprehensively analysed the variation factors for the weight-corrected...
BACKGROUND
Voriconazole (VRCZ) is commonly used as oral and intravenous (IV) formulations. Few studies have comprehensively analysed the variation factors for the weight-corrected VRCZ serum concentration/dose (C/D) ratio based on the administration route. We retrospectively investigated the risk factors that influence the VRCZ C/D ratio in patients treated with oral or IV formulations.
METHODS
A total of 325 patients were divided into two groups (IV and oral groups). Propensity score matching was performed and linear regression analyses were used to identify the risk factors that affect the VRCZ C/D ratio according to the administration route. Receiver operating characteristic (ROC) curves were also used to assess the predictive potential for VRCZ trough concentration >5 µg/mL.
RESULTS
The VRCZ C/D ratio in the oral group was significantly lower than that in the IV group (p<0.001). Propensity score matching resulted in 65 in the IV group matched with 65 in the oral group. Multivariate analysis showed that age (p=0.039), aspartate aminotransferase (AST) (p=0.016) and total bilirubin (TBIL) (p=0.041) levels were independent influencing factors of the VRCZ C/D ratio in the oral group. ROC curves showed that the predicted probability of combined age, AST and TBIL had maximal area under the curve (AUC) of 0.901 for VRCZ trough level >5 µg/mL. Meanwhile, the ratio of TBIL (p=0.005) and single dose (p=0.015) were independent factors in the IV group with ROC of 0.781.
CONCLUSIONS
To obtain optimal VRCZ efficacy and safety, dose adjustment is required based on multiple factors that may cause the observed difference in the VRCZ C/D ratio and trough levels between oral and IV administration.
Topics: Humans; Voriconazole; Antifungal Agents; Retrospective Studies; Administration, Intravenous
PubMed: 35273002
DOI: 10.1136/ejhpharm-2021-003173 -
The AAPS Journal Jan 2015Peptides are an important class of endogenous ligands that regulate key biological cascades. As such, peptides represent a promising therapeutic class with the potential... (Review)
Review
Peptides are an important class of endogenous ligands that regulate key biological cascades. As such, peptides represent a promising therapeutic class with the potential to alleviate many severe disease states. Despite their therapeutic potential, peptides frequently pose drug delivery challenges to scientists. This review introduces the physicochemical, biophysical, biopharmaceutical, and formulation developability aspects of peptides pertinent to the drug discovery-to-development interface. It introduces the relevance of these properties with respect to the delivery modalities available for peptide pharmaceuticals, with the parenteral route being the most prevalent route of administration. This review also presents characterization strategies for oral delivery of peptides with the aim of illuminating developability issues with the drug candidate. A brief overview of other routes of administration, including inhaled, transdermal, and intranasal routes, is provided as these routes are generally preferred by patients over injectables. Finally, this review presents formulation techniques to mitigate some of the developability obstacles associated with peptide delivery. The authors emphasize opportunities for the thoughtful application of pharmaceutical science to the development of peptide drugs and to the general advancement of this promising class of pharmaceuticals.
Topics: Chemistry, Pharmaceutical; Drug Administration Routes; Drug Delivery Systems; Drug Design; Humans; Patient Preference; Peptides
PubMed: 25398427
DOI: 10.1208/s12248-014-9688-2 -
Lab Animal Mar 2009Anesthesia in rabbits is generally straightforward but can be complicated by certain characteristics of rabbits. This column describes the process of administering...
Anesthesia in rabbits is generally straightforward but can be complicated by certain characteristics of rabbits. This column describes the process of administering anesthesia to rabbits.
Topics: Anesthesia; Animals; Drug Administration Routes; Intubation; Monitoring, Intraoperative; Rabbits; Veterinary Medicine
PubMed: 19229224
DOI: 10.1038/laban0309-84 -
Gynecologic and Obstetric Investigation 1990The anal and oral administration routes were compared in 40 rats to study the distribution of misonidazole (MIS), a radiation sensitizer, in the serum, uterus and...
The anal and oral administration routes were compared in 40 rats to study the distribution of misonidazole (MIS), a radiation sensitizer, in the serum, uterus and vagina. 14C-labelled MIS was administered in a dose of 0.2 ml water/100 g body weight containing 1 microCi MIS. The dose was given orally in 20 rats and was injected in the anal submucosa in another 20 rats. Animals were then sacrificed after 15, 30, 60 or 120 min or after 24 h. Serum samples was taken at the time of sacrifice; organs were dissected and radioactivity was determined in each by the internal standard method. The study has shown that the highest drug concentration in uterus and vagina relative to serum was achieved by the anal submucosal route. They showed a drug concentration of 10 and 8 times, respectively, of the serum level after 15 min in contrast to oral administration, which in the same period of time produced a drug concentration of 1/5 and 1/4 the serum level. The anal route thus offers an adequate channel for MIS administration to promote radiation responsiveness in cancer of uterus and vagina.
Topics: Administration, Oral; Administration, Rectal; Animals; Drug Administration Routes; Female; Injections; Misonidazole; Pelvic Neoplasms; Rats; Tissue Distribution; Uterus; Vagina
PubMed: 2358197
DOI: 10.1159/000293388