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Published on: February 26, 2013
Designing Microneedle Patch for Prophylaxis of Postoperative Atrial Fibrillation
Mingrui Cui1, Wenshuo Wang2, Xiaoyue Han1
1Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Biological Science and Medical Engineering, Donghua University, Shanghai 201620, China.
Abstract:
Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, which often occurs within 30 postoperative days, especially peaking at 2-3 days. Antiarrhythmic medications such as amiodarone are recommended in clinical practice for the prophylaxis and treatment of POAF. However, conventional oral administration is hindered due to delayed drug action and high risks of systemic toxicity, and emerging localized delivery strategies suffer from a limited release duration (less than 30 days). Herein, we develop a microneedle (MN) patch for localized delivery of amiodarone to the atria in a "First Rapid and Then Sustained" dual-release mode. Specifically, this patch is composed of a needle array integrated with an amiodarone-loaded reservoir for a sustained and steady release for over 30 days; and an amiodarone-containing coating film deposited on the needle surface via the Langmuir-Blodgett technique for a rapid release at the first day. Upon this design, only one MN patch enables a higher drug accumulation in the atrial tissue at the first day than oral administration and simultaneously remains therapeutical levels for over 30 days, despite at a significantly reduced drug dosage (5.08 mg in total versus ∼10 mg per day), thereby achieving ideal preventive effects and safety in a rat model. Our findings indicate that this MN device provides a robust and efficient delivery platform for long-term prophylaxis of POAF.
Insights
A novel microneedle patch delivers amiodarone for preventing postoperative atrial fibrillation (POAF). This patch offers rapid and sustained release, improving efficacy and safety over oral methods.
Area of Science:
- Biomaterials Science
- Cardiovascular Pharmacology
- Drug Delivery Systems
Background:
- Postoperative atrial fibrillation (POAF) is a frequent complication after cardiac surgery.
- Current treatments like oral amiodarone have limitations including delayed action and systemic toxicity.
- Existing localized delivery methods offer insufficient release duration for POAF prophylaxis.
Purpose of the Study:
- To develop a microneedle (MN) patch for localized, dual-mode (rapid and sustained) amiodarone delivery to the atria.
- To evaluate the efficacy and safety of the MN patch for preventing POAF in a rat model.
- To establish a long-term prophylaxis strategy for POAF.
Main Methods:
- Fabrication of a microneedle patch with an amiodarone-loaded reservoir for sustained release.
- Application of an amiodarone-containing coating on needle surfaces for rapid release using the Langmuir-Blodgett technique.
- Assessment of drug accumulation, therapeutic levels, and preventive effects in a rat model.
Main Results:
- The MN patch achieved higher atrial drug accumulation on day one compared to oral administration.
- Therapeutic amiodarone levels were maintained for over 30 days with a single MN patch application.
- The MN patch demonstrated ideal preventive effects and safety with a significantly reduced total drug dosage.
Conclusions:
- The developed microneedle patch provides an efficient and robust platform for localized, long-term amiodarone delivery.
- This dual-release MN system offers a promising strategy for the prophylaxis of postoperative atrial fibrillation.
- The findings support the potential of microneedle technology in managing cardiac surgical complications.
