Nardelli Silvia, Pisani Laura Francesca, Tontini Gian Eugenio, Vecchi Maurizio, Pastorelli Luca
Department of Gastroenterology, 'Sapienza' Università di Roma, Viale dell'Università 37, 00161, Roma, Italy.
Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Therap Adv Gastroenterol. 2017 Jul;10(7):545-552. doi: 10.1177/1756283X17709974. Epub 2017 May 25.
The Multimatrix (MMX) preparation MMX is a recently obtained drug formulation developed to facilitate release of high concentrations of active drugs into the colon, with a homogeneous distribution along all colonic segments, particularly the most distal ones; the distal colonic tracts, indeed, are the most difficult to reach in significant amounts when a drug is given orally. The MMX formulation is characterized by a lipophilic matrix dispersed in a hydrophilic structure. Indeed, in the last few years, MMX technology has been widely used in the development of various drugs for the treatment of inflammatory and infectious gastrointestinal diseases localized in the colon. In particular, MMX mesalamine, budesonide and parnaparin formulations have been investigated in patients with ulcerative colitis, and the first two have reached worldwide registration for the treatment of this disease. Moreover, MMX-rifamycin is being positively tested in the treatment of colonic bacterial infections, including traveler's diarrhea. MMX technology is, thus, proving to be a very effective formulation for the treatment of various colonic diseases. This effectiveness has been related not only to specific colonic delivery, but also to its ability to act in a once-daily dosage, thus favouring patients' adherence to prescribed schedules of treatment. The effective delivery of the active molecule to the site of need in the colon is also associated with very low systemic absorption and very low rates of adverse events (AEs). In this paper, we have reviewed all clinical trials performed with an MMX-bound drug and all possible real-life reports, in order to give an overall evaluation of MMX.
多矩阵（MMX）制剂 MMX是一种最近获得的药物制剂，旨在促进高浓度活性药物释放到结肠中，并沿所有结肠段均匀分布，尤其是最远端的结肠段；实际上，口服给药时，远端结肠段最难达到有效剂量。MMX制剂的特点是亲脂性基质分散在亲水性结构中。事实上，在过去几年中，MMX技术已广泛应用于开发各种用于治疗结肠局部炎症性和感染性胃肠道疾病的药物。特别是，已对溃疡性结肠炎患者研究了MMX美沙拉嗪、布地奈德和帕纳肝素制剂，前两种已在全球范围内获批用于治疗该疾病。此外，MMX-利福霉素正在积极测试用于治疗包括旅行者腹泻在内的结肠细菌感染。因此，MMX技术被证明是治疗各种结肠疾病的非常有效的制剂。这种有效性不仅与特定的结肠给药有关，还与其每日一次给药的作用能力有关，从而有利于患者遵守规定的治疗方案。活性分子有效递送至结肠所需部位还与极低的全身吸收和极低的不良事件（AE）发生率相关。在本文中，我们回顾了所有使用MMX结合药物进行的临床试验以及所有可能的实际病例报告，以便对MMX进行全面评估。
