Customized 3D printed multi-drug systems: an effective and efficient approach to polypharmacy

ABSTRACT

Introduction

Combination therapies continue to improve therapeutic outcomes as currently achieved by polypharmacy. Since the introduction of the polypill, there has been a significant improvement in adherence and patient outcomes. However, the mass production of polypills presents a number of technical, formulation, and clinical challenges. The current one-size-fits-all approach ignores the unique clinical demands of patients, necessitating the adoption of a more versatile tool. That will be the novel, but not so novel, 3D printing.

Areas covered

The present review investigates this promising paradigm shift from one medication for all, to customized medicines, providing an overview of the current state of 3D-printed multi-active pharmaceutical forms, techniques applied and printing materials. Details on cost implications, as well as potential limitations and challenges are also elaborated.

Expert opinion

3D printing of multi-active systems, is not only beneficial but also essential. With growing interest in this field, a shift in manufacturing, prescribing, and administration patterns is, at this point, unavoidable. Addressing limitations and challenges, as well as data presentation on clinical trial results, will aid in the acceleration of this technology’s implementation. However, it is clear that 3D printing is not the end of it, as evidenced by the emerging 4D printing technology.

KEYWORDS:

• 3D-printing
• customized
• multi-drug systems
• polypharmacy
• polypill

Article highlights

• 3D printing has been presented as a faultless intervention, capable of producing a solid object at the push of a button; this is clearly not the case.

• Limitations and challenges in the areas of processing and management and more importantly regulatory constraints have been identified as significant obstacles in its full adoption.

• 3D printing of medicals, and more germane to this study, multi-active systems, is not only beneficial but also essential.

• Employees will need to enhance their education and skill levels in order for organizations to implement 3D printing, as well as obtain experience in various physicochemical and biological features of active pharmaceutical ingredients (APIs).

• The ability to modulate the release of different actives in multi-drug systems forms the bases upon which polymers are selected in the 3D printing thereof.

• The mass production of the polypill has been criticized for its one-size-fits-all approach, which disregards individual patient needs as some patients may require higher or lower dosages of particular active moieties within the formulation, while others may not require all of the drugs contained within the formulation.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by the National Research Foundation (NRF) South Africa [Grant No.: 64814]. The content is solely the responsibility of the authors and does not necessarily represent the official views of National Research Foundation.