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Prospective pulmonary drug delivery system of pirfenidone
microparticles for pulmonary fibrosis
Uqie Shabrina Hasyyati
1
, Silvia Surini
1*
, Gatot Suhariyono Suhariyono
2
1
Laboratory of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
2
Nuclear Metrology and Quality Safety Technology Research Center - Nuclear Power Research Organization, National Research and Innovation Agency,
Tangerang Selatan, Indonesia.
ARTICLE INFO
Available Online: XX
Key words:
Pirfenidone, pulmonary
delivery, pulmonary fibrosis,
microparticle, cytotoxicity
study.
ABSTRACT
Orally administered pirfenidone in pulmonary fbrosis therapy induces numerous systemic adverse effects. This
study aims to develop pirfenidone microparticles for pulmonary delivery to reduce the systemic adverse effects of
pirfenidone. Ten formulations of pirfenidone microparticles were prepared using the spray drying method, including
sodium carboxymethyl cellulose and sodium alginate as polymers, ammonium bicarbonate as porogen, and L-leucine
as dispersing agent. These microparticles were evaluated using physicochemical characterization, stability, and in vitro
cytotoxicity studies. The F10 formulation, which consisted of sodium alginate 1.0%, ammonium bicarbonate 0.3%,
and L-leucine 0.4%, had the most relevant results for inhalation. The mass median aerodynamic diameters (MMADs)
of F10 were 0.065, 0.597, 2.212, and 5.626 µm, ideal for deposition in the bronchiolar to the alveolar region. The
stability study showed that the pirfenidone contents were 99.08%–100.00% and 98.83%–100.00%, with an increasing
MMAD up to 5.895 and 6.273 µm at 30°C ± 2°C and 40°C ± 2°C, respectively. The in vitro cytotoxicity study
revealed that the pulmonary epithelial cells (A549 cells) were less sensitive to the excipients in the formulation than
pirfenidone (p = 0.018). Furthermore, F10 caused signifcantly lower interleukin-6 release than pirfenidone (p < 0.05).
In conclusion, F10 shows suitable characteristics for pulmonary pirfenidone delivery in pulmonary fbrosis therapy.
INTRODUCTION
Pirfenidone, an anti-infammation, antioxidant, and
antifbrotic drug, is used in treating pulmonary fbrosis, such as
idiopathic pulmonary fbrosis (IPF) (Canestaro et al., 2016). IPF
is a progressive, chronic, age-related interstitial lung disease. It
is expected to increase as the population ages, with an average
untreated life expectancy of 3–5 years after diagnosis (Spagnolo
et al., 2021). Pirfenidone has also been studied in clinical trials
to treat post-COVID-19 pulmonary fbrosis (Bazdyrev et al.,
2021), reported in patients with severe and moderate COVID-19
based on artifcial intelligence analysis (Halawa et al., 2021). A
meta-analysis study concluded that about 44.9% of COVID-19
survivors appear to have developed pulmonary fbrosis, which
may mainly persist over time (Hama Amin et al., 2022). Fibrosis
causes stiffness in the walls of the alveolus, which reduces the
lungs’ functional capacity and disrupts the respiratory process. A
persistent decline in lung function can be fatal (Martinez et al.,
2017; Spagnolo et al., 2021).
In the current treatment of pulmonary fbrosis,
pirfenidone is taken orally in high doses (up to 2,403 mg/day)
(Sayf, 2021). However, this route could lead to therapeutic
discontinuation due to systemic adverse effects, including
photosensitivity, gastrointestinal problems, anorexia, tiredness,
and dizziness (Lancaster et al., 2017). Consequently, numerous
studies have been conducted to identify an alternative route for
pirfenidone administration. Delivering pirfenidone to the lungs
through pulmonary delivery could reduce systemic exposure
and subsequently reduce its adverse effect (Khoo et al., 2020).
Pulmonary delivery also offers other benefts, such as reducing
drug doses, duration, and the cost of the therapy (Putri et al., 2022).
*Corresponding Author
Silvia Surini, Laboratory of Pharmaceutics and Pharmaceutical Technology,
Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
E-mail: silvia @ farmasi.ui.ac.id
© 2023 Uqie Shabrina Hasyyati et al. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License
(https://creativecommons.org/licenses/by/4.0/).
Journal of Applied Pharmaceutical Science Vol. 0(00), pp 001-011, 2023
DOI: 10.7324/JAPS.2023.125985
Received on: 31/02/2023
Accepted on: 27/05/2023