1. Introduction
Three-dimensional printing (3DP) has recently been attracting the attention of the pharmaceutical community because it allows patient-centric design and production of dosage forms, according to the individual needs of a specific patient [
1]. Fused Deposition Modelling (FDM), one of the most used 3DP techniques, relies on the previous production of a drug-containing thermoplastic polymeric filament. The FDM 3D-printer is fed with the filament, which is molten at high temperature, extruded, and continuously deposited on the printer plate, layer by layer, building the 3D-printed dosage form. Hot-melt extrusion (HME) is the most interesting method to manufacture the filaments, using existing pharmaceutical-grade polymers [
2].
The success of FDM for medicine customization depends on several factors, such as the choice of the adequate polymeric matrix, according to the intended drug release profile. Recently, cellulose-derived polymers have been increasingly used for filament preparation by HME. Cellulose ethers encompass a category of polymers designed by the linking of cellulose to alkyl substituents, such as methyl (methylcellulose, MC), ethyl (ethylcellulose, EC) and propyl (hydroxypropylcellulose, HPC) groups.
Among the cellulosic polymers, HPC (
Figure 1) has been extensively studied, in several works, for application in integrated HME-FDM 3DP [
3]. Typically, HPC polymers exhibit plasticity and hydrophobicity, high solubility in water and organic solvents, and a low Tg (0–120 °C, which tends to decrease with increasing moisture due to the plasticizer effect of water).
Since HPC polymers are marketed with different viscosities and molecular weight grades (Klucel
TM ELF, EF, LF, JF, GF, MF, and HF;
Table 1) they can be used in pharmacy to modulate the drug release profile [
4]. In fact, the drug release rate depends on the polymer viscosity, which in turn is affected by the molecular weight and temperature.
As these matrix polymers have not been developed specifically for 3DP applications, it is crucial to evaluate their properties both alone and in the presence of the drug and adjuvants. Polymers can affect the characteristics of the final formulation, such as their aqueous solubility, erosion, and/or swelling properties. The mechanical and rheological properties of the filaments determine the quality and behavior (e.g., immediate or delayed release) of the final dosage form produced and are largely dependent on the matrix. Furthermore, drug release can be adjusted by the addition of excipients (e.g., disintegrants, surfactants, and/or pore builders) and by printing specimens with different infills or geometries [
3].
Based on a comparative study of the drug dissolution profile, this work reports the selection of the most suitable grade of HPC polymer to modulate the release of paroxetine (PRX; used for the treatment of major depression, generalized anxiety, and related disorders) from 3D-printed tablets obtained by HME coupled to FDM 3DP.
2. Materials and Methods
PRX (Lusifar, Lisbon, Portugal) was used as a model drug; as matrix-forming polymers, hydroxypropylcellulose (HPC; KlucelTM LF and KlucelTM GF Pharm, Ashland Inc., Schaffhausen, Switzerland) were used. Magnesium stearate (MgS) (Roic Pharma, Terrasa, Barcelona, Spain), dicalcium dihydrate phosphate (CaP) (Budenheim, Rheinstrasse, Germany), and triethylcitrate (TEC) (Sigma Aldrich, Darmstadt, Germany) were used as excipients. Paroxetine film-coated tablets 20 mg (Tecnimede Group, Sintra, Portugal) were used as commercial references.
The extrusion of physical mixtures of the raw materials was performed in a single-screw extruder (Noztec Pro, Noztek, Shoreham, UK) at temperatures of 120 °C and 90 °C (barrel with two heating sections), at a constant screw speed (10 rpm). Two different polymeric formulations (HPCTM LF and HPCTM GF) were considered. Tablets were 3D-printed by FDM (3D printer Delta WASP 20 40 Turbo 2, Massa Lombarda, Italy) from PRX-loaded filaments, according to a digital template (3D Sprint Software v2.11, 3D Systems, Rock Hill, SC, USA) and exported as a stereolithography (.stl) file into Cura (v15.04.2, Ultimaker B.V., Utrecht, The Netherlands). The tablets (10 mm diameter × 3 mm thick cylinders; 0.7 mm layer width × 1.4 mm wall thickness; 100% infill) were printed at a temperature of 200 °C and a 60 mm/s printing speed.
In vitro dissolution of the 3D-printed tablets was performed, and kinetic parameters, such as the time required for 50% drug release (t
50%) and the dissolution rate (DR), were calculated [
5].
3. Results and Discussion
Previous work demonstrated the feasibility of PRX-based formulations to be ex-truded by HME into filaments, which could be used to manufacture 3D-printed tablets by FDM. The polymeric formulation containing PRX (30%
w/
w), HPC (54%
w/
w), and excipients (16%
w/
w of CaP, MgS, and TEC) exhibited the most adequate behavior, among those studied, for coupling both technologies [
6].
Nevertheless, it remained unclear which HPC polymer grade (KlucelTM LF and KlucelTM GF) was the most suitable to use. In terms of the manufacturing process (extrudability and printability), no significant differences were observed by the use of any of the HPC polymer grades considered. Thus, the selection criterion was directed towards the quality attributes of the 3D-printed dosage forms produced. In particular, it was defined that the best HPC candidate would be the one capable of producing a drug release profile closer to that of the commercial PRX tablets produced by tableting.
Both polymeric formulations containing Klucel
TM LF and Klucel
TM GF were used to produce filaments, and 3D-printed tablets were manufactured. A comparative study of the in vitro dissolution profile of both 3D-printed dosage forms was carried out (
Figure 2), and the kinetic parameters were evaluated (
Table 2).
The dissolution exhibited a profile typically associated with controlled release formulations, particularly useful in the treatment of psychiatric diseases and related to the use of the HPC polymer in both formulations, regardless of its grade. For the polymeric formulation composed of KlucelTM LF, the release of ≥85% of PRX was observed for ≈6 h of the test, reaching the steady state (release close to 100%) after 8 h. The release profile was superimposable to that of the commercial formulation obtained by a conventional tableting process; the similarity of the dissolution profiles between both formulations was supported by an f2 test, which exhibited a value higher than 50 (71, i.e., good similarity). This finding suggested that coupling HME and FDM technologies can produce 3D-dosage forms with drug release kinetics similar to those commercially available. Although the dissolution profiles were similar, the kinetics of drug release are amenable to adjustments leading to complete overlapping of the profiles, namely by modulating the polymer:PRX ratio or the adjuvants present in the formulation.
On the contrary, the polymeric formulation containing KlucelTM GF presented a slower PRX release rate, as inferred by higher t50% values and lower DR results, when compared to the KlucelTM LF-based polymeric formulation. In this scope, the increase in the HPC viscosity associated with the higher molecular weight of KlucelTM GF, impaired the release of the drug. Likewise, the dissolution profile was not comparable with the commercial formulation, despite the f2 factor being close to 50 (48, i.e., almost similar). In fact, more than 8 h were required for ≥85% of the PRX to be released from 3D-printed tablets composed of KlucelTM GF polymeric formulation (even though it reached 100% at the end of dissolution test). The potential for further extending drug action with this formulation is apparent and is the subject of future investigation.
Overall, this work supports the selection of the KlucelTM LF polymeric matrix as the best option, among those studied, to manufacture 3D-printed PRX tablets by integrated HME-FDM, as a therapeutic strategy in the treatment of psychiatric diseases. 3DP is proven to be capable of mimicking the drug release of commercial formulations with the added value of possible customization according to the patient needs.
Author Contributions
Conceptualization, S.F., A.I.F. and J.F.P.; methodology, investigation, and formal analysis, S.F.; writing—original draft preparation, S.F.; writing—review and editing, A.I.F.; resources, F.G.C., A.I.F. and J.F.P.; project administration, and funding acquisition, A.I.F. and J.F.P. All authors have read and agreed to the published version of the manuscript.
Funding
This work was supported by the Fundação para a Ciência e a Tecnologia, grant number PTDC/CTM CTM/30949/2017 (Lisboa 010145 Feder 030949).
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Not applicable.
Data Availability Statement
Data are not publicly available.
Acknowledgments
Klucel™ HPC samples courtesy of Ashland Inc.
Conflicts of Interest
The authors declare no conflict of interest.
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