Impact of gastrointestinal disease states on oral drug absorption - implications for formulation design - a PEARRL review

The Journal of Pharmacy and Pharmacology
Angela EffingerNikoletta Fotaki

Abstract

Drug product performance in patients with gastrointestinal (GI) diseases can be altered compared to healthy subjects due to pathophysiological changes. In this review, relevant differences in patients with inflammatory bowel diseases, coeliac disease, irritable bowel syndrome and short bowel syndrome are discussed and possible in vitro and in silico tools to predict drug product performance in this patient population are assessed. Drug product performance was altered in patients with GI diseases compared to healthy subjects, as assessed in a limited number of studies for some drugs. Underlying causes can be observed pathophysiological alterations such as the differences in GI transit time, the composition of the GI fluids and GI permeability. Additionally, alterations in the abundance of metabolising enzymes and transporter systems were observed. The effect of the GI diseases on each parameter is not always evident as it may depend on the location and the state of the disease. The impact of the pathophysiological change on drug bioavailability depends on the physicochemical characteristics of the drug, the pharmaceutical formulation and drug metabolism. In vitro and in silico methods to predict drug product performance in patie...Continue Reading

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Citations

Dec 6, 2020·Clinical and Translational Science·Carrie A VyhlidalValentina Shakhnovich
Nov 10, 2020·European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences·Angela EffingerNikoletta Fotaki
Jan 24, 2021·European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences·Hai-Ni WenZheng Jiao
Feb 29, 2020·European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences·Cordula StillhartAnette Müllertz
Feb 22, 2021·Advanced Drug Delivery Reviews·Zahari VinarovPatrick Augustijns
Jul 11, 2020·European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences·Angela EffingerNikoletta Fotaki
Mar 14, 2021·Journal of the Science of Food and Agriculture·Juan HanGuo-Peng Miao
Oct 12, 2020·Biochemical Pharmacology·Bianca N QuadeRossana Occhipinti

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