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F

DA defines personalised medicine as providing ‘the right

patient with the right drug at the right dose at the right time’.

With current advances, the ability to estimate the

susceptibility of a particular drug for an individual patient using

genomic profiling, and the ability to deliver drugs to a specific cell

or organ by homing to its ‘signatures’ on the cells without

adversely acting on other non-targeted cells, has revolutionised

the pharmaceutical industry by providing us with a wider scope of

‘personalised’ medicine.

In our laboratories at UCLan, we have specific focuses on

nanomedicines for targeted drug delivery to cancer and infectious

diseases. Specialist equipment required for the development and

characterisation of novel polymeric and lipidic therapeutic drug

delivery systems for pulmonary and transdermal delivery are

available in our research laboratories. These nano-based systems

have also successfully been used to show improved therapeutic

effect in purposely designed

in vitro

and

in vivo

models. Potential

for improved clinical applications on these nano-based systems

warrant further investigation, particularly for the understanding on

molecular targets and uptake mechanisms.

Personalising the dose and drug combination

One major implication of personalised medicine is the

personalisation of dose and drug combination, this could simply

relate to the dose adjustments required for drug treatments for

patients with, for example, hepatic or renal impairment, where the

therapeutic and toxic response to the drugs may vary significantly.

Clinical data indicated different therapeutic responses from

individuals with varied disease manifestations and tolerance.

To help improve a patient’s outcome and responses, the demand

for a unique medical approach tailored for individual patients is

on the rise. The development of pharmacogenomics enables a

more patient-specific approach to dosing and dose combinations,

instead of using the standard mass produced medicines based

on a ‘One Size Fits All’ concept.

1

The use of a dose dispenser to

produce medicines as per a patient’s demand would therefore be

an attractive approach to address the challenges of personalised

medicine. An ‘ideal’ dose dispenser used for such medicine

production should be highly adjustable, affordable, controllable by

network, and of minimal space requirements. More importantly, it

should also allow the production of safe, efficacious and good

quality products.

An integrated solution

In an increasingly connected smart living society, patients will be

surrounded by different type of sensors in addition to purpose-

built detectors implanted in their own bodies. These developments

open the door for a valuable opportunity to have a flowing in-line

information about an individual’s physiological parameters and

responses to a given treatment. This creates new possibilities of

future scenarios where tablets are produced via a mini-dispenser

in response to the individual’s clinical needs, and following

healthcare specialists’ orders through an integrated healthcare

network. The suggested strategy allows faster and more efficient

use of healthcare resources by adopting a more holistic approach

towards medical care.

Current solutions

Modifying the solid dosage form has mainly been carried out

through using multiple low-dose tablets or splitting and dividing

larger ones. The introduction of a score in the middle of tablets

allows a simple dose adjustment for halving the tablet. However,

the use of the splitter is difficult for some groups of patients, for

instance the elderly and patients with arthritis. In addition,

splitting solid dosage forms, such as a tablet, could result in

dosing inaccuracy and destroy the release kinetics of modified

release preparations that are designed for controlled and

extended release of the active drug.

2-4

Coated preparations,

including enteric-coated products, could also be affected where

the coating is generally used to prevent premature degradation of

the drug in the stomach, or protect patients from the drug, or

influence drug deposition site and deposition time.

One common method of dose personalisation is the exploitation

of liquid dosage forms. Personalisation has been easily achieved

by altering the volumes of these preparations to be administered

5

via the use of various dosing aids that form part of the packaging.

However, its manufacturing equipment occupies large spaces and

implicates significant increase in dosage form volume and costs.

Moreover, formulating a drug in a liquid dosage form is usually

3D printing could change the way we make tablets and tailor them on demand

to suit a particular patient’s need

Personalised dose

132

I S S U E S E V E N

H O R I Z O N 2 0 2 0 P R O J E C T S : P O R TA L

www.horizon2020projects.com

P R O F I L E

S O C I E TA L C H A L L E N G E S : H E A L T H & W E L L B E I N G

Fig. 1 A 3D printer can function as a mini-dispenser to tailor an

individual patient’s dose in response to a changing clinical data

(source: UCLan)