Randomized Controlled Trial Comparing the Efficacy and Safety of Epidural Infiltration of Particulate Versus Nonparticulate Steroids in the Treatment of Patients with Sciatic Pain

Introduction: Epidural corticosteroid injections are widely used to treat low back pain, but doubts exist about the relative efficacy of particulate versus non-particulate corticosteroids. Epidural corticosteroid injections were performed in 75 patients with chronic radicular pain were evaluated for epidural corticosteroid injections to determine if there was a difference in the efficacy of triamcilone acetate, methylprednisolone acetate, and dexamethasone. Methods: 75 patients presenting with debilitating radicular pain were randomized to receive an injection of triamcilone acetate 40 mg/ml, methylprednisolone acetate 40 mg/ml, and dexamethasone phosphate 7.5 mg/ml at equal doses. Data were collected at 1-month and 3-month follow-up. The primary outcome of the present study was reduction in pain on a visual analog scale (VAS) at 3 months, while the secondary outcome was the type and number of complications in the study group. Results: Regardless of baseline score VAS, pain score decreased in all patients at one and three months. The patients with VAS of very severe also showed a statistically significant success rate at one and three month follow-up [p= 0.043]. No serious complications occurred in all three groups. Conclusion: According to this study, pain relief and functional improvement are similar among all three methylprednisolone acetate, triamcilone acetate and dexamethasone phosphate at 3 months.

Enzymatically Crosslinked In Situ Synthesized Silk/Gelatin/Calcium Phosphate Hydrogels for Drug Delivery

Our research focuses on combining the valuable properties of silk fibroin (SF) and calcium phosphate (CaP). SF is a natural protein with an easily modifiable structure; CaP is a mineral found in the human body. Most of the new age biocomposites lack interaction between organic/inorganic phase, thus SF/CaP composite could not only mimic the natural bone, but could also be used to make drug delivery systems as well, which can ensure both healing and regeneration. CaP was synthesized in situ in SF at different pH values, and then crosslinked with gelatin (G), horseradish peroxide (HRP), and hydrogen peroxide (H2O2). In addition, dexamethasone phosphate (DEX) was incorporated in the hydrogel and drug delivery kinetics was studied. Hydrogel made at pH 10.0 was found to have the highest gel fraction 110.24%, swelling degree 956.32%, and sustained drug delivery for 72 h. The highest cell viability was observed for the hydrogel, which contained brushite (pH 6)—512.43%.

Investigations of Surface Interactions between PEGDA-Polymer and Drug using Surface Plasmon Resonance

For the development of combination products, the determination of the release kinetics of polymer-based drug delivery systems (DDS) is a central and often timeconsuming investigation. Classical methods are often unsuitable for large-scale screening of potential polymers for combination products. We present a rapid method based on surface plasmon resonance spectroscopy (SPR), using PEGDA700 (Poly(ethylene glycol) diacrylate, average molecular weight (Mn) 700) as an example. This method is capable of determinating the kinetics of drug association and subsequent release within minutes. The proportion of desorption and diffusion can be determined separately. Surface plasmon resonance spectroscopy (SPR) is a label-free and very sensitive optical technique, which allows for real-time observation of surface interactions. The prepared SPR chips were spin-coated with PEGDA700 and crosslinked via photoinduced polymerization. The association and dissociation kinetics of dexamethasone phosphate in swollen PEGDA700 have been studied at different concentrations. The maximum loading of the surface was also obtained by this method. The study of PEGDA presented here identified the wellestablished SPR-based spectroscopy as a potential tool in the development of combination products.

Population pharmacokinetic modeling of intramuscular and oral dexamethasone and betamethasone in Indian women

Population analysis of pharmacokinetic data for five differing dosage forms and routes for dexamethasone and betamethasone in 48 healthy nonpregnant Indian women was performed that accounted for a partial and complex cross-over design. Single doses of 6 mg dexamethasone phosphate (DEX-P), betamethasone phosphate (BET-P), or 1:1 mixture of betamethasone phosphate and acetate (BET-PA) were administered orally (PO) or intramuscularly (IM). Plasma concentrations collected for two periods over 96 h were described with a two-compartment model with differing PO and IM first-order absorption inputs. Clearances and volumes were divided by the IM bioavailability $${F}_{IM}$$ F IM . The homogeneous ages, body weights, and ethnicity of the women obviated covariate analysis. Parameter estimates were obtained by the Laplace estimation method implemented in NONMEM 7.4. Typical values for dexamethasone were clearance ($${CL/F}_{IM})$$ C L / F IM ) of 9.29 L/h, steady-state volume ($${{V}_{ss}/F}_{IM})$$ V ss / F IM ) of 56.4 L, IM absorption constant $$\left({k}_{aIM}\right)$$ k aIM of 0.460 1/h and oral absorption constant ($${k}_{aPO})$$ k aPO ) of 0.936 1/h. Betamethasone parameters were CL/FIM of 5.95 L/h, $${Vss/F}_{IM}$$ V s s / F IM of 72.4 L, $${k}_{aIM}$$ k aIM of 0.971 1/h, and $${k}_{aPO}$$ k aPO of 1.21 1/h. The PO to IM F values were close to 1.0 for both drugs. The terminal half-lives averaged about 7.5 h for DEX, 17 h for BET, and 78 h for BET from BET-PA with the latter reflecting very slow release of BET from the acetate ester. Overall, BET exhibited slower clearance, larger volume of distribution, faster absorption, and longer persistence than DEX. These data may be useful in considering exposures when substituting one form of corticosteroid for another.

Biocompatibility and Therapeutic Effect of 3 Intra-Tympanic Drug Delivery Vehicles in Acute Acoustic Trauma

<b><i>Introduction:</i></b> The aim of this study was to assess the biocompatibility of several intra-tympanic (IT) drug delivery vehicles and to compare hearing outcomes. <b><i>Materials and Methods:</i></b> After acute acoustic trauma, rats were treated with IT 10 mg/mL dexamethasone phosphate (D) and divided into the following groups for drug delivery: saline + D (<i>n</i> = 15), hyaluronic acid (HA) + D (<i>n</i> = 17), and methoxy polyethylene glycol-<i>b</i>-polycaprolactone block copolymer (MP) + D (<i>n</i> = 24). <b><i>Results:</i></b> No inflammation was found in the saline + D or HA + D groups. The duration of vehicle/drug persistence in the bulla was significantly longer for the MP + D (47.5 days) and HA + D groups (1.8 days) than for the saline + D group (&#x3c;1 day). The tympanic membrane was significantly thicker in the MP + D group than in the saline + D and HA + D groups. The proportion of ears with good hearing outcome was significantly higher (63.6%) in the HA + D group than in the MP + D group. The number of hair cells in the hearing loss (HL) control group was significantly lower than in the MP + D group. <b><i>Discussion/Conclusion:</i></b> HA shows great potential as a biocompatible vehicle for D delivery via the IT route, without an inflammatory reaction and with better hearing outcomes. Considering inflammation and hearing, MP may not be a good candidate for IT drug delivery.