Advanced implantable drug delivery technologies: transforming the clinical landscape of therapeutics for chronic diseases
Advanced implantable drug delivery technologies: transforming the clinical landscape of therapeutics for chronic diseases
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DOI：
10.1007/s10544-019-0389-6
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发表时间：
2019-06-01
影响因子：
2.8
通讯作者：
Grattoni，Alessandro
中科院分区：
文献类型：
--
作者：
Pons-Faudoa，Fernanda P.;Ballerini，Andrea;Grattoni，Alessandro
慢性病占全球所有死亡人数的大部分，预计其流行率将在未来10年内上升。由于慢性疾病需要长期治疗，医疗保健系统必须满足越来越多患者的需求。使用新的给药途径，特别是植入式给药装置，有可能减少治疗监测临床就诊和与医疗保健提供者的随访。此外，植入式药物输送装置的设计可以保持治疗窗口中的药物浓度，以实现治疗药物在较长时间内的受控、持续释放，消除患者不遵守口服治疗的风险。如果将该装置植入受影响的组织，可以实现更高的局部药物浓度，从而减少全身不良副作用，并减少非肠道治疗的挑战和不适。尽管植入式药物输送设备已经存在了一段时间，但人们对其治疗潜力的兴趣正在增长，到2018年，全球市场预计将达到120亿美元以上。这篇综述讨论了处于开发后期或临床应用阶段的植入性药物释放技术，重点介绍了储存库植入物的最新技术，包括泵、机电系统和聚合物、植入部位和副作用，以及在发展中国家的部署。
Chronic diseases account for the majority of all deaths worldwide, and their prevalence is expected to escalate in the next 10 years. Because chronic disorders require long-term therapy, the healthcare system must address the needs of an increasing number of patients. The use of new drug administration routes, specifically implantable drug delivery devices, has the potential to reduce treatment-monitoring clinical visits and follow-ups with healthcare providers. Also, implantable drug delivery devices can be designed to maintain drug concentrations in the therapeutic window to achieve controlled, continuous release of therapeutics over extended periods, eliminating the risk of patient non-compliance to oral treatment. A higher local drug concentration can be achieved if the device is implanted in the affected tissue, reducing systemic adverse side effects and decreasing the challenges and discomfort of parenteral treatment. Although implantable drug delivery devices have existed for some time, interest in their therapeutic potential is growing, with a global market expected to reach over $12 billion USD by 2018. This review discusses implantable drug delivery technologies in an advanced stage of development or in clinical use and focuses on the state-of-the-art of reservoir-based implants including pumps, electromechanical systems, and polymers, sites of implantation and side effects, and deployment in developing countries.