Intramuscular Diffusion Status of Risperidone and Aripiprazole Long Acting Injectable (LAI) by Ultrasonography

Yasuhara, Yuko; Tanioka, Tetsuya; Takase, Kensaku; Motoki, Kazushi; Watari, Chie; Makiguchi, Koichi; Atsuta, Asumi; Locsin, Rozzano C.

doi:10.4236/ojpsych.2016.62020

Cited by 4 publications

(6 citation statements)

References 22 publications

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“…Computed tomography has been used to assess LA injectable depot location variability between gluteal muscle and SC adipose fat and, in doing so, has been used to determine the association between BMI and IM misinjections 28,34 . Ultrasonography has traditionally been used to guide injectable therapies to the intended locations and has also been used in conjunction with elastography to characterize the dispersion and physiochemical properties of the drug 13,14 . Although MRI cannot be used to visualize the active drug substance in a solid‐suspension formulation like cabotegravir LA, traditional excipients (e.g., oil, polyethylene glycol, mannitol, water) generate adequate MRI signal for detection and discrimination from biologic tissue‐based signal 30,32,35 .…”

Section: Discussionmentioning

confidence: 99%

“… 28 , 34 Ultrasonography has traditionally been used to guide injectable therapies to the intended locations and has also been used in conjunction with elastography to characterize the dispersion and physiochemical properties of the drug. 13 , 14 Although MRI cannot be used to visualize the active drug substance in a solid‐suspension formulation like cabotegravir LA, traditional excipients (e.g., oil, polyethylene glycol, mannitol, water) generate adequate MRI signal for detection and discrimination from biologic tissue‐based signal. 30 , 32 , 35 Magnetic resonance imaging was also used to assess drug depot volume expansion in a patient receiving an intragluteal injection of diclofenac 2 mL in which a rapid increase in depot volume over the initial 24 hours was observed.…”

Section: Discussionmentioning

confidence: 99%

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Multiparametric magnetic resonance imaging to characterize cabotegravir long‐acting formulation depot kinetics in healthy adult volunteers

Jucker

Fuchs

Lee³

et al. 2021

Brit J Clinical Pharma

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Cabotegravir long-acting (LA) intramuscular (IM) injection is being investigated for HIV preexposure prophylaxis due to its potent antiretroviral activity and infrequent dosing requirement. A subset of healthy adult volunteers participating in a Phase I study assessing cabotegravir tissue pharmacokinetics underwent serial magnetic resonance imaging (MRI) to assess drug depot localization and kinetics following a single cabotegravir LA IM targeted injection. Methods: Eight participants (four men, four women) were administered cabotegravir LA 600 mg under ultrasonographic-guided injection targeting the gluteal muscles. MRI was performed to determine injection-site location in gluteal muscle (IM), subcutaneous (SC) adipose tissue and combined IM/SC compartments, and to quantify drug depot characteristics, including volume and surface area, on Days 1 (≤2 hours postinjection), 3 and 8. Linear regression analysis examined correlations between MRI-derived parameters and plasma cabotegravir exposure metrics, including maximum observed concentration (C max ) and partial area under the concentration-time curve (AUC) through Weeks 4 and 8. Results: Cabotegravir LA depot locations varied by participant and were identified in the IM compartment (n = 2), combined IM/SC compartments (n = 4), SC compartment (n = 1) and retroperitoneal cavity (n = 1). Although several MRI parameter and exposure metric correlations were determined, total depot surface area on Day 1 strongly correlated with plasma cabotegravir concentration at Days 3 and 8, C max and partial AUC through Weeks 4 and 8.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multiparametric magnetic resonance imaging to characterize cabotegravir long‐acting formulation depot kinetics in healthy adult volunteers

Jucker

Fuchs

Lee³

et al. 2021

Brit J Clinical Pharma

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“…All ultrasonographic measurements were performed by an experienced Sonographer using a 7.5 MHz linear and convex array transducer and ultrasonograph diagnostic system (Hitachi Medical Corporation, Japan). Figure 1 is an example of ultrasonographic image [18].…”

Section: Measurement By Ultrasonographymentioning

confidence: 99%

Comparison of Gluteal Muscle Intramuscular Injection Sites of Japanese Healthy Subjects: Considerations for Optimal Insertion of Injection Needle Length

Masuda¹,

Yasuhara²,

Tanioka³

et al. 2016

OJPsych

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Long Acting Injectable (LAI) medications for patients with schizophrenia is commonly administered to relieve their symptoms. Through shared decision-making and clinical evidence-based, psychiatrists should systematically offer LAIs to all patients requiring long-term antipsychotic treatment as a first-line treatment. Gluteal intramuscular (IM) injection requires accurate insertion of needles into the specific muscle area, often the outer upper quadrant of the buttocks, in order to achieve the required blood concentration. The purposes of this study were to compare the "Distance from the Epidermis to the Under-Fascia (DEUF)" and "Distance from the Epidermis to the Iliac Bone (DEB)" of the buttocks IM injection sites at the dorsogluteal and ventrogluteal sites among healthy Japanese volunteer subjects, and to identify the optimal insertion injection needle length. The DEUF and DEB at the gluteal regions were measured by ultrasonography. Welch's one-way analysis of variance was used to compare the DEUF and the DEB at the gluteal IM injection regions. There was no statistically significant difference observed between the right and left mean values of DEUF for Hochstetter and Clark's point at the ventrogluteal sites, and the Four and Three-way split or Double Cross point at the dorsogluteal sites. However in the DEB, the Hochstetter's point (P < 0.01) at ventrogluteal site on the right side, and Clark's point (P < 0.05) were significantly shorter than the Double Cross point at dorsogluteal sites (F = 4.38). The left buttocks S. Masuda et al. 204 Hochstetter's point was significantly shorter than the Double Cross point (F = 4.38, P < 0.01). These results, however, did not establish a statistically significant difference in the DEUF among injection sites. It was considered that the difference in the DEB depended on muscle volume and thickness in the gluteal injection sites.

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“…Also, it was observed that both RLAI and ALAI were depicted as having high echogenicity with acoustic shadowing and high echogenic mass in the gluteus medius 15) . Quantitative diagnostic ultrasound imaging has been proposed as a method for estimating muscle quality using measures of echogenicity 16) .…”

Section: Evaluations Of Muscle Echogenicities In Patients Treated Witmentioning

confidence: 99%

Evaluations of muscle echogenicities in patients treated with second generation long acting injectable antipsychotics

et al. 2017

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IntroductionAntipsychotic depots or long-acting injections were introduced in the 1960s as a means of improving medication adherence and thereby enhancing desired clinical outcomes 1) . Several first-generation (FG)-long-acting injectable antipsychotics (LAIs) and three second-generation LAIs (SG-LAIs) are currently available for administration into either the gluteal or deltoid muscle. These LAIs are administered by intramuscular (IM) injection. A single injection effect lasts within the range of 1 week to 3 months, depending on the compound and formulation 2,3) . Our previous study evaluated the B-mode findings of the muscle infiltrated with second generation long acting injectable antipsychotics (SG-LAIs). SG-LAIs were seen as a high-echogenicity mass with marked acoustic shadowing in the gluteus medius muscle. The aim of this study was to examine the echogenicities of the muscle with SG-LAI. This study demonstrated 3 patients with schizophrenia under treatment with risperidone (RLAI), paliperidone (PLAI) and aripiprazole (ALAI) (one case each). Quantitative diagnostic ultrasound imaging has been proposed as a method of estimating muscle quality using echogenicities. Grayscale histogram analysis of Photoshop Premiere Elements 14.0 was used to determine the muscle tissue echogenicity in a region of interest (ROI). The pre-and post-injected SG-LAI echogenicities were analyzed using a paired t-test with a significance level of 5%. Each SG-LAIs could be illustrated as high echogenic masses with acoustic shadowing. The corresponding grayscale histogram values of selected ROI in the injected muscles were significantly increased in all cases. It was considered that the diffusion states of SG-LAIs by ultrasonography were important time course evaluations providing objective evidence. Evaluations of muscle echogenicities in patients treated

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Intramuscular Diffusion Status of Risperidone and Aripiprazole Long Acting Injectable (LAI) by Ultrasonography

Cited by 4 publications

References 22 publications

Multiparametric magnetic resonance imaging to characterize cabotegravir long‐acting formulation depot kinetics in healthy adult volunteers

Multiparametric magnetic resonance imaging to characterize cabotegravir long‐acting formulation depot kinetics in healthy adult volunteers

Comparison of Gluteal Muscle Intramuscular Injection Sites of Japanese Healthy Subjects: Considerations for Optimal Insertion of Injection Needle Length

Evaluations of muscle echogenicities in patients treated with second generation long acting injectable antipsychotics

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