Rheological and Drug Delivery Characteristics of Poloxamer-Based Diclofenac Sodium Formulations for Chronic Wound Site Analgesia
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pharmaceutics Article Rheological and Drug Delivery Characteristics of Poloxamer-Based Diclofenac Sodium Formulations for Chronic Wound Site Analgesia Jackson Russo 1 , Jennifer Fiegel 2 and Nicole K. Brogden 1,3,* 1 Department of Pharmaceutical Sciences and Experimental Therapeutics, The University of Iowa, Iowa City, IA 52242, USA; [email protected] 2 Department of Chemical and Biochemical Engineering, The University of Iowa, Iowa City, IA 52242, USA; jennifer-fi[email protected] 3 Department of Dermatology, The University of Iowa, Iowa City, IA 52242, USA * Correspondence: [email protected] Received: 12 November 2020; Accepted: 11 December 2020; Published: 15 December 2020 Abstract: Chronic wounds are a significant and growing health problem, and clinical treatment is often a painful experience. A topical dosage form would be optimal to treat this pain. Poloxamer 407, a thermosensitive polymer that is a liquid at low temperatures but gels at higher temperatures, is well suited to administer topical analgesics to chronic wound sites. The goal of this study was to evaluate the gelation and drug delivery properties of poloxamer 407 gels containing diclofenac sodium for potential use in chronic wound analgesic delivery. The gelation properties of poloxamer formulations were evaluated rheologically. Drug delivery properties of poloxamers loaded with diclofenac sodium were evaluated using snakeskin dialysis membranes, intact porcine ear skin, and porcine ear skin impaired via tape stripping. A commercial gel product and a solution of diclofenac sodium in water were used as control formulations. Poloxamer concentration and gelation temperature varied inversely, and the addition of higher concentrations of diclofenac sodium correlated to significant increases in poloxamer gelation temperature. Poloxamer solutions were effective in limiting the permeation of diclofenac sodium through membranes with impaired barrier properties, and delivery of diclofenac sodium from poloxamer 407 did not vary significantly from delivery observed from the commercial gel product. The amount of drug delivered in 24 h did not change significantly with changes in poloxamer 407 concentration. The results of this study indicate that poloxamer 407 may be a useful formulation component for administration of an analgesic product to a chronic wound site. Keywords: topical; poloxamer; thermogelation; chronic wounds; analgesia 1. Introduction The skin is the largest organ of the body and is key to maintaining homeostasis, with a unique layered structure that provides a barrier to harmful external materials and maintains body temperature and moisture [1–3]. However, as the body’s most exposed organ, the skin is also prone to external insults that can create open wounds and compromise its critical homeostatic functions. While most wounds heal in a timely manner, around 6.5 million Americans annually suffer from chronic wounds that undergo a greatly prolonged healing process [4]. Pain management correlates with shortened wound healing times and improved patient outcomes and thus is key to improving the quality of life for patients suffering from chronic wounds [5–8]. Systemic analgesic compounds such as orally administered non-steroidal anti-inflammatory drugs (NSAIDs) and opioids can provide pain relief. However, ongoing administration of these compounds Pharmaceutics 2020, 12, 1214; doi:10.3390/pharmaceutics12121214 www.mdpi.com/journal/pharmaceutics PharmaceuticsPharmaceutics2020 2020, 12, ,12 1214, x FOR PEER REVIEW 2 of2 of 18 19 drugs (NSAIDs) and opioids can provide pain relief. However, ongoing administration of these overcompounds the duration over ofthe a duration prolonged of a treatmentprolonged course treatment can course lead to can adverse lead to eadverseffects. effects. Prolonged Prolonged oral administrationoral administration of NSAIDs of NSAIDs is associated is associated with with peptic peptic ulcer ulcer formation formation and and renal renal failure, failure, particularly particularly inin elderly elderly patients. patients. Long-term Long-term administration administration of of systemic systemic opioids opioids is is associated associated with with constipation, constipation, respiratoryrespiratory depression, depression, and and potential potential for for addiction addiction and and misuse misuse [9, 10[9,10].]. AA topical topical analgesic analgesic product product would would limit limit systemic systemic exposure exposure and and mitigate mitigate systemic systemic adverse adverse eff effectsects whilewhile providing providing localized localized pain pain management management in in the the wound. wound. However, However, the the administration administration of of a topicala topical productproduct is likelyis likely to to involve involve prolonged prolonged wound wound site site contact, contact, which which could could increase increase the the pain pain involved involved in in woundwound dressing dressing changes changes [11 [11,12].,12]. Administration Administration of of a therapeutica therapeutic compound compound directly directly into into a wounda wound cancan also also result result in in rapid rapid absorption absorption of of the the drug drug due due to to the the lack lack of of a skina skin barrier, barrier, which which would would diminish diminish locallocal analgesic analgesic effi efficacycacy [13 [13].]. In In order order to to reduce reduce the the frequency frequency of of analgesic analgesic reapplication reapplication and and dressing dressing changes,changes, and and limit limit rapid rapid systemic systemic absorption, absorption, it it is is importantimportant thatthat aa drugdrug depot source is is provided provided to tooffer offer prolonged local deliverydelivery ofof thethe analgesicanalgesic compound.compound. AA productproduct thatthat can can be be applied applied with with minimalminimal contact contact to to the the wound wound site site itself itself while while providing providing a slow-releasea slow-release depot depot of of an an analgesic analgesic drug drug wouldwould therefore therefore be be a significanta significant advance advance in in the the optimization optimization of chronicof chronic wound wound pain pain management. management. ThermosensitiveThermosensitive polymers polymers that that undergo undergo reverse reverse thermal thermal gelation gelation are are well well suited suited to to meet meet the the uniqueunique challenges challenges presented presented by by chronic chronic wounds. wounds. Reverse Reverse thermal thermal gelation gelation is is the the process process by by which which a a polymerpolymer transitions transitions from from a liquid a liquid state state at at low low temperatures temperatures to to a gela gel state state when when heated heated [14 [14]—the]—the liquid liquid toto gel gel transition transition of poloxamer of poloxamer 407 is 407 shown is shown in Figure in 1Figure. Polymers 1. Polymers that undergo that reverseundergo thermal reverse gelation thermal couldgelation be administered could be administered as cool liquids as cool with liquids minimal with wound minimal site contact, wound and site a contact, gel would and form a gel within would theform wound within site the to provide wound asite local to depotprovide source a local of thedepot analgesic. source Poloxamerof the analgesic. 407 is aPoloxamer thermosensitive 407 is a polymerthermosensitive vehicle that polymer has low vehicle toxicity, that lack has of low skin toxici irritation,ty, lack and of reverse skin irritation, thermal gelationand reverse properties. thermal Ingelation addition, properties. poloxamer In 407 addition, systems containingpoloxamer a 407 variety systems of drug containing compounds, a variety including of drug small-molecule compounds, drugsincluding and proteins, small-molecule have been drugs shown and proteins, to remain have stable been as solutionsshown to whenremain stored stable at as 4 solutions◦C for up when to 3 monthsstored at [15 4 ,°C16]. for It up has to been 3 months studied [15,16]. for use It in has transdermal been studied delivery, for use often in transdermal in combination delivery, with eitheroften in permeationcombination enhancers with either or microneedles, permeation enhancers to overcome or themicroneedles, barrier properties to overcome of the the skin barrier [17]. However, properties poloxamerof the skin 407 [17]. is However, similarly promisingpoloxamer for407 use is simila in therly delivery promising of analgesicsfor use in the to chronicdelivery wounds of analgesics by prolongingto chronic release wounds of by a topically prolonging administered release of a analgesic topically compound administered to aanalgesic site that compound does not have to a an site intactthat skindoes barrier. not have an intact skin barrier. FigureFigure 1. 1.Solution Solution of of 20% 20%w/ ww/wpoloxamer poloxamer 407 407 in in water water (A )(A at) 4at◦ 4C °C prior prior to to heating heating and and (B ()B after) after heating heating onon a stira stir plate plate until until gelation gelation occurred, occurred, causing causing the the stir stir bar bar to stopto stop moving. moving. Past studies have been conducted exploring thermosensitive polymers as potential formulation ingredients to deliver analgesic compounds, but the delivery of an analgesic compound topically to a chronic wound site has not yet been adequately explored. A series of studies was conducted to Pharmaceutics 2020, 12, 1214 3 of 18 Past studies have been conducted