Abstract:
Advanced age can have a significant impact on oral drug absorption, primarily due to age-related changes in the gastrointestinal (GI) tract and other physiological processes. In this research webinar, we focus on current knowledge gaps of physiological characteristics influencing the biopharmaceutical performance of oral medicines including, among others, the gastric emptying time and characterization of the luminal gastrointestinal fluids. Up to date, published data on gastric emptying of non-caloric liquids (i.e. water) in older people are insufficient. To close this gap, a non-invasive method for the determination of gastric water emptying in fasted and fed state has been developed and validated in younger volunteers. Due to its simplicity, it can be used to study gastric emptying kinetics in a larger proportion of older individuals, including those for whom other invasive methods are difficult to apply. Whether advanced age has an impact on characteristics of luminal fluids, such as the volume, pH, acid outputs, buffer capacity, osmolality, composition and concentration of bile salts, and activity of digestive enzymes, has not been clarified. Existing data are limited, while an impact of comorbidities that are common among older population has not been addressed. Given the high prevalence of multimorbidity and polypharmacy of this special population, addressing age-associated physiological changes can optimize oral drug delivery and improve treatment outcomes.