High-amylose carboxymethyl starch matrices for oral sustained drug-release: In vitro and in vivo evaluation

Unmodified and modified starches represent a particularly interesting group of biodegradable and abundant excipients. They have been widely used as excipients for various purposes in tablet formulations, such as binders and/or disintegrants. Spray-dried high-amylose sodium carboxymethyl starch (SD HASCA) was recently proposed as an innovating hydrophilic excipient for sustained-release (SR) in solid oral dosage forms. Amorphous high-amylose sodium carboxymethyl starch (HASCA) was first produced by the etherification of high-amylose corn starch with chloroacetate. HASCA was then spray dried to obtain SD HASCA. This new excipient has shown advantageous and effective properties in the production of SR delivery systems. SR matrix tablets prepared from SD HASCA are inexpensive, simple to formulate and easy to produce by direct compression.;The main objective of the present research was to continue the development and optimization of matrix tablets using SD HASCA as the retarding excipient in view of their ultimate application as sustained drug-release delivery systems for oral administration. For this purpose, dissolution tests simulating some of the most relevant physiological conditions of the gastrointestinal tract, taking into account the nature of the polymer under investigation, were employed to evaluate the drug-release characteristics and demonstrate the performance of SD HASCA SR formulations. An exploratory clinical study was also carried out to evaluate the SR properties of this new drug delivery system in the gastrointestinal tract.;The first article presented in this thesis evaluated the drug-release characteristics and the physical integrity of formulations containing a compressed blend of drug, sodium chloride and SD HASCA in biorelevant media. The influence of different acidic pH values and residence times was investigated. The SR profile from an optimized SD HASCA formulation was not significantly affected by both the acidic pH value and the residence time in the acidic medium. These results suggest a limited influence of intra- and inter-subject variability of gastric pH on the release kinetics from SD HASCA matrices. In addition, the optimized formulation maintained its integrity throughout the duration of the dissolution tests. The exploratory in vivo study demonstrated extended drug absorption after oral administration of SD HASCA matrix tablets and that the matrix tablets did not disintegrate while passing through the stomach and resisted hydrolysis by alpha-amylase in the intestine.;The second article reports the development of once-daily and twice-daily SD HASCA tablets containing tramadol hydrochloride (100 mg and 200 mg). These SR formulations presented high crushing strengths without requiring the addition of binders, which facilitates tablet processing and handling. The compression force (CF) applied to produce the tablets did not significantly affect the drug-release profiles. The total release time from SD HASCA tablets increased significantly in function of the tablet weight and can be used to modulate the total release time from theses formulations. When exposed to a pH gradient and to a 40% ethanol medium, a very rigid gel formed progressively on the surface of the tablets providing controlled drug-release properties. These properties indicated that SD HASCA is a robust excipient for oral, sustained drug-release, likely to minimize the possibility of dose dumping and consequent adverse effects, even when co-administered with high doses of alcohol.;The third article investigated the effect of alpha-amylase on drug-release from previously developed SD HASCA tablets containing acetaminophen and tramadol hydrochloride (Acetaminophen SR and Tramadol SR). Mathematical modeling showed that an increase in alpha-amylase concentration resulted in an increase of polymer erosion over drug diffusion as the main mechanism controlling drug-release, for both formulations and both residence times in acidic medium. However, even if the mechanism of release was affected, alpha-amylase concentrations ranging from 0 IU/L to 20000 IU/L did not significantly affect the drug-release profiles from SD HASCA SR tablets, regardless of the residence time in acidic medium, the drug used, the polymer content and the different composition of each formulation.;The work presented in this thesis clearly demonstrates the value of SD HASCA as an efficient SR excipient.;Keywords: oral drug delivery; sustained-release; hydrophilic excipient; modified starch; high-amylose; matrix tablet; in vitro; in vivo; alpha-amylase.