Department of Nanomedicine, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX, 77030, USA.
School of Medicine and Health Sciences, Tecnologico de Monterrey, Avenida Eugenio Garza Sada 2501, 64849, Monterrey, NL, Mexico.
Biomed Microdevices. 2019 May 18;21(2):47. doi: 10.1007/s10544-019-0389-6.
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.
慢性疾病占全球所有死亡人数的大部分，预计在未来 10 年内其发病率将上升。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。使用新的药物给药途径，特别是植入式药物输送装置，有可能减少治疗监测的临床就诊次数和与医疗保健提供者的随访次数。此外，植入式药物输送装置可以设计为将药物浓度维持在治疗窗内，以实现治疗药物的持续、控制释放，从而消除患者对口服治疗的不依从性风险。如果将装置植入受影响的组织中，可以实现更高的局部药物浓度，从而减少全身不良反应，并减少肠外治疗的挑战和不适。尽管植入式药物输送装置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，预计到 2018 年，全球市场规模将超过 120 亿美元。本综述讨论了处于开发后期或临床使用阶段的植入式药物输送技术，重点介绍了基于储库的植入物的最新技术，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应用。
