Skin permeation and penetration of mometasone furoate in the presence of emollients: An ex vivo evaluation of clinical application protocols

Abstract Background Topical corticosteroids (TCS) and emollients are developed independently by the pharmaceutical industry but are often used together in practice. There is potential for the TCS and emollient formulations to interact on the skin surface affecting TCS absorption into the skin. Clini...

Full description

Bibliographic Details
Main Authors: Mubinah T. Beebeejaun, Marc B. Brown, Victoria Hutter, Laura Kravitz, William J. McAuley
Format: Article
Language:English
Published: Wiley 2023-06-01
Series:Skin Health and Disease
Online Access:https://doi.org/10.1002/ski2.215
_version_ 1797814359006642176
author Mubinah T. Beebeejaun
Marc B. Brown
Victoria Hutter
Laura Kravitz
William J. McAuley
author_facet Mubinah T. Beebeejaun
Marc B. Brown
Victoria Hutter
Laura Kravitz
William J. McAuley
author_sort Mubinah T. Beebeejaun
collection DOAJ
description Abstract Background Topical corticosteroids (TCS) and emollients are developed independently by the pharmaceutical industry but are often used together in practice. There is potential for the TCS and emollient formulations to interact on the skin surface affecting TCS absorption into the skin. Clinical guidelines acknowledge this issue but lack an evidence base and differ in their recommendations. There is a current clinical need to establish whether the application protocol employed for TCS and emollient products can impact delivery of TCS to the skin. Objectives To investigate whether the sequence of application of a TCS and emollient and the time between their application can affect TCS skin absorption. Methods The delivery of mometasone furoate (MF) to ex vivo human skin was evaluated following the application of Elocon cream either 5 or 30 min, before and after three different emollients. Mechanistic explanation of the changes in drug absorption was provided by modelling the skin permeation data and Raman microscopy of mixed Elocon cream and emollient formulations. Results A circa fivefold difference in MF absorption was observed depending on the emollient and application protocol. Applying Elocon cream at short intervals in relation to Hydromol intensive significantly increased MF absorption regardless of the application protocol. In contrast, applying Elocon cream after Diprobase cream or ointment significantly reduced MF absorption relative to Elocon cream alone or when Elocon cream was applied before these emollients. The changes in drug absorption observed were attributed to the presence of emollients altering Elocon cream formulation performance through different mechanisms, including introduction of penetration enhancing excipients and inducing drug crystallization in the mixed TCS emollient layer on the skin surface. Conclusions Emollients can affect MF absorption in different ways depending on the emollient and sequence of administration. Using a 30 min gap between product applications may not be sufficient to mitigate emollient effects on TCS absorption.
first_indexed 2024-03-13T08:06:32Z
format Article
id doaj.art-9c5df7c1317c45198f0bcec03d84da33
institution Directory Open Access Journal
issn 2690-442X
language English
last_indexed 2024-03-13T08:06:32Z
publishDate 2023-06-01
publisher Wiley
record_format Article
series Skin Health and Disease
spelling doaj.art-9c5df7c1317c45198f0bcec03d84da332023-06-01T05:13:40ZengWileySkin Health and Disease2690-442X2023-06-0133n/an/a10.1002/ski2.215Skin permeation and penetration of mometasone furoate in the presence of emollients: An ex vivo evaluation of clinical application protocolsMubinah T. Beebeejaun0Marc B. Brown1Victoria Hutter2Laura Kravitz3William J. McAuley4Centre for Research in Topical Drug Delivery and Toxicology University of Hertfordshire Hatfield UKMedPharm Ltd. Guildford UKCentre for Research in Topical Drug Delivery and Toxicology University of Hertfordshire Hatfield UKCentre for Research in Topical Drug Delivery and Toxicology University of Hertfordshire Hatfield UKCentre for Research in Topical Drug Delivery and Toxicology University of Hertfordshire Hatfield UKAbstract Background Topical corticosteroids (TCS) and emollients are developed independently by the pharmaceutical industry but are often used together in practice. There is potential for the TCS and emollient formulations to interact on the skin surface affecting TCS absorption into the skin. Clinical guidelines acknowledge this issue but lack an evidence base and differ in their recommendations. There is a current clinical need to establish whether the application protocol employed for TCS and emollient products can impact delivery of TCS to the skin. Objectives To investigate whether the sequence of application of a TCS and emollient and the time between their application can affect TCS skin absorption. Methods The delivery of mometasone furoate (MF) to ex vivo human skin was evaluated following the application of Elocon cream either 5 or 30 min, before and after three different emollients. Mechanistic explanation of the changes in drug absorption was provided by modelling the skin permeation data and Raman microscopy of mixed Elocon cream and emollient formulations. Results A circa fivefold difference in MF absorption was observed depending on the emollient and application protocol. Applying Elocon cream at short intervals in relation to Hydromol intensive significantly increased MF absorption regardless of the application protocol. In contrast, applying Elocon cream after Diprobase cream or ointment significantly reduced MF absorption relative to Elocon cream alone or when Elocon cream was applied before these emollients. The changes in drug absorption observed were attributed to the presence of emollients altering Elocon cream formulation performance through different mechanisms, including introduction of penetration enhancing excipients and inducing drug crystallization in the mixed TCS emollient layer on the skin surface. Conclusions Emollients can affect MF absorption in different ways depending on the emollient and sequence of administration. Using a 30 min gap between product applications may not be sufficient to mitigate emollient effects on TCS absorption.https://doi.org/10.1002/ski2.215
spellingShingle Mubinah T. Beebeejaun
Marc B. Brown
Victoria Hutter
Laura Kravitz
William J. McAuley
Skin permeation and penetration of mometasone furoate in the presence of emollients: An ex vivo evaluation of clinical application protocols
Skin Health and Disease
title Skin permeation and penetration of mometasone furoate in the presence of emollients: An ex vivo evaluation of clinical application protocols
title_full Skin permeation and penetration of mometasone furoate in the presence of emollients: An ex vivo evaluation of clinical application protocols
title_fullStr Skin permeation and penetration of mometasone furoate in the presence of emollients: An ex vivo evaluation of clinical application protocols
title_full_unstemmed Skin permeation and penetration of mometasone furoate in the presence of emollients: An ex vivo evaluation of clinical application protocols
title_short Skin permeation and penetration of mometasone furoate in the presence of emollients: An ex vivo evaluation of clinical application protocols
title_sort skin permeation and penetration of mometasone furoate in the presence of emollients an ex vivo evaluation of clinical application protocols
url https://doi.org/10.1002/ski2.215
work_keys_str_mv AT mubinahtbeebeejaun skinpermeationandpenetrationofmometasonefuroateinthepresenceofemollientsanexvivoevaluationofclinicalapplicationprotocols
AT marcbbrown skinpermeationandpenetrationofmometasonefuroateinthepresenceofemollientsanexvivoevaluationofclinicalapplicationprotocols
AT victoriahutter skinpermeationandpenetrationofmometasonefuroateinthepresenceofemollientsanexvivoevaluationofclinicalapplicationprotocols
AT laurakravitz skinpermeationandpenetrationofmometasonefuroateinthepresenceofemollientsanexvivoevaluationofclinicalapplicationprotocols
AT williamjmcauley skinpermeationandpenetrationofmometasonefuroateinthepresenceofemollientsanexvivoevaluationofclinicalapplicationprotocols