Box 7.5 Controlled-release drug delivery using biodegradable polymeric microspheres
Conventional dosage methods, such as oral delivery and injection, are not ideally suited for sustained
drug delivery to diseased tissues or organs of the body. Ingesting a tablet or injecting a bolus of drug
dissolved in aqueous solution causes the drug to be rapidly released into the body. Drug concentrations
in blood or tissue can rise to nearly toxic levels followed by a drop to ineffective levels. The duration over
which an optimum drug concentration range is maintained in the body, i.e. the period of deriving
maximum therapeutic benefit, may be too short. To maintain an effective drug concentration in the
blood, high drug dosages, as well as frequent administration, become necessary.
When a drug is orally administered, in order to be available to different tissues, the drug must first
enter the bloodstream after absorption in the gastrointestinal tract. The rate and extent of absorption may
vary greatly, depending on the physical and chemical form of the drug, presence or absence of food,
posture, pH of gastrointestinal fluids, duration of time spent in the esophagus and stomach, and drug
interactions. Uncontrolled rapid release of drug can cause local gastrointestinal toxicity, while slow or
incomplete absorption may prevent realization of therapeutic benefit.
In recent years, more sophisticated drugs in the form of protein-based and DNA-based com-
pounds have been introduced. However, oral delivery of proteins to the systemic circulation is
particularly challenging. For the drug to be of any use, the proteins must be able to pass through the
gastrointestinal tract without being enzymatically degraded. Many of these drugs have a small
therapeutic concentration range, with the toxic concentration range close to the therapeutic range.
Research interest is focused on the development of controlled-release drug-delivery systems that can
maintain the therapeutic efficacy of such drugs. Controlling the precise level of drug in the body
reduces side-effects, lowers dosage requirements and frequency, and enables a predictable and
extended duration of action. Current controlled-release drug-delivery technologies include trans-
dermal patches, implants, microencapsulation, and inhaled and injectable sustained-release peptide/
protein drugs.
An example of a controlled-release drug-delivery system is the polymer microsphere. Injection of
particulate suspensions of drug-loaded biodegradable polymeric spheres is a convenient method to
deliver hormonal proteins or peptides in a controlled manner. The drug dissolves into the
surrounding medium at a pre-determined rate governed by the diffusion of drug out of the polymer
and/or by degradation of the polymer. Examples of commercially available devices for sustained
drug release are Gliadel (implantable polyanhydride wafers that release drug at a constant rate as
the polymer degrades) for treating brain cancer, Lupron Depot (injectable polymer microspheres) for
endometriosis and prostate cancer, and Nutropin Depot for pituitary dwarfism. Lupron Depot
(leuprolide) is a suspension of microspheres made of poly-lactic-glycolic acid (PLGA) polymer
containing leuprolide acetate, and is administered once a month as an intramuscular injection. The
drug is slowly released into the blood to maintain a steady plasma concentration of leuprolide for
one month.
Since controlled-release drug-loaded microparticles are usually injected into the body, thereby
bypassing intestinal digestion and first-pass liver metabolism, one must ensure that the polymeric
drug carrier material is non-toxic, degrades within a reasonable time frame, and is excreted from the
body without any accumulation in the tissues. Biodegradable polymers gradually dissolve in body
fluids either due to enzymatic cleavage of polymer chains or hydrolytic breakdown (hydrolysis) of the
polymer. PLGA is an example of a biocompatible polymer (polyester) that is completely biodegrad-
able. As sections of the polymer chains in the outer layers of the drug–polymeric system are cleaved
and undergo dissolution into the surrounding medium, drug located in the interior becomes exposed
to the medium. The surrounding fluid may penetrate into the polymer mass, thereby expediting drug
diffusion out of the particle. Transport of drug molecules from within the polymeric mass to the
surrounding tissues or fluid is governed by several mechanisms that occur either serially or in
parallel. Mathematical formulation of the diffusional processes that govern controlled release is far
from trivial.
Here, we avoid dealing with the par tial differential equations used to model the diffusion of drug in
time and space within the particle and in the surrounding medium. We make the simplifying assumption
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Numerical integration of ODEs