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Microneedle biosensors for real-time, minimally invasive drug monitoring of phenoxymethylpenicillin: a first-in-human evaluation in healthy volunteers / Sanjiv, Sharma
The Lancet Digital Health, Volume: 1, Issue: 7, Pages: e335 - e343
Swansea University Author: Sanjiv, Sharma
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Background: We report the first-in-human evaluation of realtime penicillin monitoring using a microneedle-based beta-lactam biosensor.Methods: Participants taking phenoxymethylpenicillin (penicillin-V) at steady state had venous blood (via cannula, T=- 30,0,10,20,30,45,60,90,120,150,180,210,240mins)...
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Background: We report the first-in-human evaluation of realtime penicillin monitoring using a microneedle-based beta-lactam biosensor.Methods: Participants taking phenoxymethylpenicillin (penicillin-V) at steady state had venous blood (via cannula, T=- 30,0,10,20,30,45,60,90,120,150,180,210,240mins) and extracellular fluid (ECF; via microdialysis, every 15mins) pharmacokinetic (PK) samples taken during one dosing interval. During this period, a solid microneedle betalactam biosensor was worn to provide real-time monitoring of ECF penicillin-V concentration. Penicillin-V concentration data obtained from the microneedles was calibrated using locally-estimated-scatter-plot smoothing and compared to free blood and microdialysis (gold standard) data. Penicillin-V PK for each method was evaluated using noncompartmental analysis. Area-under-the-concentration-time-curve (AUC), Cmax, and tmax were compared. Bias and limits of agreement were investigated with Bland-Altman plots. Microneedle biosensor limits of detection were estimated. The study was approved by London-HarrowRegional ethics committee (Ref:18/LO/0054, NCT03847610).Findings: Ten healthy volunteers participated. Mean (SD) age was 42 (14) years. Seven (70%) were male. Penicillin-V ECF determined through microdialysis and microneedle methods demonstrated similar Cmax (0.74mg/L vs. 0.64mg/L, p=0.53; 95%CI: -0.24;0.44), tmax (1.18hrs vs. 1.10hrs, p=0.79; 95%CI:-0.52;0.67), and AUC (1.54mg*h/L vs. 1.67 mg*h/L p=0.79;95%CI:-1.10;0.85). In total, 440 time points were compared with mean (95%CI) difference between measurements -0.15 mg/L (95%CI:-0.11;0.20). Mean (SD) penicillin-V AUC values for free serum and microneedle PK were similar at 1.77 (0.59) mg*h/L and 1.67 (1.06) mg*h/L, respectively (p=0.81; 95%CI:-0.77;0.97). Percentage coefficient of variation betweensensors within individuals was median (IQR) 7 (4-17)%. Limit of detection for the microneedles was estimated at 0.17 mg/L.Interpretation: This demonstrates proof-of-concept of real-time, microneedle sensing of penicillin in vivo. Future work will explore microneedle use in patient populations, their role in data generation to inform dosing recommendations, and their incorporation into closed-loop control systems for automated drug delivery.