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Dosage Personalization in Modern Medicine
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Dosage Personalization in Modern Medicine

A special issue of Journal of Personalized Medicine (ISSN 2075-4426).

Deadline for manuscript submissions: closed (20 September 2012) | Viewed by 30131

Special Issue Editors

Prof. Dr. Jean-Michel Cardot

E-Mail Website
Guest Editor
Faculty of Pharmacy, Biopharmaceutical Department, Université Blaise Pascal, 28 Place H. Dunant, BP 38, 63001 Clermont-Ferrand, France
Interests: IVIVC; pharmacokinetics; in vitro dissolution; formulations
Dr. Pascale Gauthier

E-Mail
Guest Editor
Biopharmaceutics Department, Faculty of Pharmacy, 63000 Clermont-Ferrand, France
Interests: pharmaceutical design; drug adaptation; pediatric; elderly; new dosage forms
Prof. Dr. Krassen Dimitrov

E-Mail Website
Guest Editor
Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, QLD 4072, Australia
Interests: biomarkers; diagnostics; platforms; single-molecule detection; biosensors

Special Issue Information

Dear Colleagues,

Integrating specific needs of younger or elderly patients with the aim to improve their observance seems to be a real challenge for future drugs.
Elderly represent a huge target, but children and teenagers must also be carefully studied regarding as future adults that they will become, also consumers for a long time.

Offering new dispensing systems in pharmaceutical field appears increasingly important. Devices and 'ready to use' products can be helpful for consumers who require new systems to help them to follow treatments more effectively thanks to appropriate design. A drug more properly taken thanks to a more adapted design will be more efficient. An evolution in terms of specifications and future prospects in relation to new formulations will be proposed in a special issue on 'dosage personalization in modern medicine'.

Prof. Dr. Jean-Michel Cardot
Dr. Pascale Gauthier
Prof. Dr. Krassen Dimitrov
Guest Editors

Keywords

  • dose
  • dosing
  • personalization
  • hemostasis
  • therapeutic range
  • thrombosis
  • anticoagulants
  • thrombolytics
  • elderly
  • children
  • teenagers

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Published Papers (4 papers)

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Research

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465 KiB  
Article
Pattern of Timing Adherence Could Guide Recommendations for Personalized Intake Schedules
by Philipp Walter, Isabelle Arnet, Michel Romanens, Dimitrios A. Tsakiris and Kurt E. Hersberger
J. Pers. Med. 2012, 2(4), 267-276; https://doi.org/10.3390/jpm2040267 - 28 Nov 2012
Cited by 8 | Viewed by 6398
Abstract
Deviations in execution from the prescribed drug intake schedules (timing non adherence) are frequent and may pose a substantial risk for therapeutic failure. Simple methods to monitor timing adherence with multiple drugs are missing. A new technology, i.e., the polymedication electronic monitoring [...] Read more.
Deviations in execution from the prescribed drug intake schedules (timing non adherence) are frequent and may pose a substantial risk for therapeutic failure. Simple methods to monitor timing adherence with multiple drugs are missing. A new technology, i.e., the polymedication electronic monitoring system (POEMS) attached to a multidrug punch card, was used in a clinical trial on outpatients with prescribed medicines for vascular risk reduction. The complete delineation of timing adherence allows for the calculation of objective adherence parameters and the linking of exposure with drug-drug interactions. A sub-analysis was performed on 68 patients, who were prescribed lipid lowering therapy. A smaller intake time variability of the lipid lowering drug was significantly associated with better levels of LDL-cholesterol, independently of the time of day. This finding may challenge current general recommendations for the timing of lipid lowering drugs’ intake and substantiate that inter-individual differences in timing adherence may contribute to response variability. Thus, objective parameters based on multidrug adherence monitoring should be considered as independent variables in personalized medicine. In clinical practice, personalized intake recommendations according to patients’ pattern of timing adherence may help to optimize the effectiveness of lipid lowering agents. Full article
(This article belongs to the Special Issue Dosage Personalization in Modern Medicine)
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899 KiB  
Article
Individual Oral Therapy with Immediate Release and Effervescent Formulations Delivered by the Solid Dosage Pen
by Klaus Wening, Eva Julia Laukamp, Markus Thommes and Jörg Breitkreutz
J. Pers. Med. 2012, 2(4), 217-231; https://doi.org/10.3390/jpm2040217 - 6 Nov 2012
Cited by 14 | Viewed by 7883
Abstract
New devices enabling freely selectable dosing of solid oral medications are urgently needed for personalized medicine. One approach is the use of the recently published Solid Dosage Pen, allowing flexible dosing of tablet-like sustained release slices from drug loaded extruded strands. Slices were [...] Read more.
New devices enabling freely selectable dosing of solid oral medications are urgently needed for personalized medicine. One approach is the use of the recently published Solid Dosage Pen, allowing flexible dosing of tablet-like sustained release slices from drug loaded extruded strands. Slices were suitable for oral single dosed application. The aim of the present study was the development of immediate release dosage forms for applications of the device, especially for young children. Using two model drugs, two different concepts were investigated and evaluated. Effervescent formulations were manufactured by an organic wet-extrusion process and immediate release formulations by a melt-extrusion process. Dissolution experiments were performed for both formulations to ensure the immediate release behavior. Extruded strands were individually dosed by the Solid Dosage Pen. Various doses of the two formulations were analyzed regarding uniformity of mass and content according to pharmacopoeial specifications. Proof of concept was demonstrated in both approaches as results comply with the regulatory requirements. Furthermore, storing stress tests were performed and drug formulations were characterized after storing. The results show that suitable packaging material has been selected and storage stability is probable. Full article
(This article belongs to the Special Issue Dosage Personalization in Modern Medicine)
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Review

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474 KiB  
Review
Personalized Medicine in Ophthalmology: From Pharmacogenetic Biomarkers to Therapeutic and Dosage Optimization
by Frank S. Ong, Jane Z. Kuo, Wei-Chi Wu, Ching-Yu Cheng, Wendell-Lamar B. Blackwell, Brian L. Taylor, Wayne W. Grody, Jerome I. Rotter, Chi-Chun Lai and Tien Y. Wong
J. Pers. Med. 2013, 3(1), 40-69; https://doi.org/10.3390/jpm3010040 - 5 Mar 2013
Cited by 20 | Viewed by 8544
Abstract
Rapid progress in genomics and nanotechnology continue to advance our approach to patient care, from diagnosis and prognosis, to targeting and personalization of therapeutics. However, the clinical application of molecular diagnostics in ophthalmology has been limited even though there have been demonstrations of [...] Read more.
Rapid progress in genomics and nanotechnology continue to advance our approach to patient care, from diagnosis and prognosis, to targeting and personalization of therapeutics. However, the clinical application of molecular diagnostics in ophthalmology has been limited even though there have been demonstrations of disease risk and pharmacogenetic associations. There is a high clinical need for therapeutic personalization and dosage optimization in ophthalmology and may be the focus of individualized medicine in this specialty. In several retinal conditions, such as age-related macular degeneration, diabetic macular edema, retinal vein occlusion and pre-threshold retinopathy of prematurity, anti-vascular endothelial growth factor therapeutics have resulted in enhanced outcomes. In glaucoma, recent advances in cytoskeletal agents and prostaglandin molecules that affect outflow and remodel the trabecular meshwork have demonstrated improved intraocular pressure control. Application of recent developments in nanoemulsion and polymeric micelle for targeted delivery and drug release are models of dosage optimization, increasing efficacy and improving outcomes in these major eye diseases. Full article
(This article belongs to the Special Issue Dosage Personalization in Modern Medicine)

Other

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818 KiB  
Opinion
Teenagers as a Moving Target: How Can Teenagers Be Encouraged to Accept Treatment?
by Pascale Gauthier and Jean-Michel Cardot
J. Pers. Med. 2012, 2(4), 277-286; https://doi.org/10.3390/jpm2040277 - 11 Dec 2012
Cited by 5 | Viewed by 6731
Abstract
Pediatric patients exhibit their own needs and problems and are now considered as a real patient group in which downsizing the adult formulation is not the best choice and may result in problems. Adolescence (between 12 and 18 years) is a transitional period [...] Read more.
Pediatric patients exhibit their own needs and problems and are now considered as a real patient group in which downsizing the adult formulation is not the best choice and may result in problems. Adolescence (between 12 and 18 years) is a transitional period of life from puberty to adulthood and, in this pediatric subgroup population, complex problems are observed in compliance with chronic treatments. Heterogeneity exists in this group which follows very different and sometimes short trends and tendencies and where illness can be a problem leading to stigmatization. Influence of social environment as well as friends is complex in this period of life. Teenagers have to take care of themselves and be part of the treatment including all the features of the social code of this group. Particular attention has to be paid to formulation and packaging in order to increase compliance and to suit the specific needs of this pediatric subgroup. Some examples are given for different drug forms. Full article
(This article belongs to the Special Issue Dosage Personalization in Modern Medicine)
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