Burn Center, Ghent University Hospital, Ghent, Belgium.
Department of Plastic Surgery, Ghent University Hospital, Ghent, Belgium.
J Dermatol. 2023 Apr;50(4):422-444. doi: 10.1111/1346-8138.16732. Epub 2023 Jan 26.
Intra- and transdermal administration of substances via percutaneous injection is effective but considered painful, and inconvenient in addition to bringing forth biohazardous waste material. In contrast to injection, topical drug application, which includes ointments, creams and lotions, increases the local drug load. Moreover, it has reduced side effects compared to systemic administration. However, the epidermis poses a barrier to high molecular weight substances, limiting the delivery efficiency. Dissolving microneedles (DMN) are hydrophilic, mostly polymer-based constructs that are capable of skin penetration and were developed to provide painless and direct dermal drug delivery. This systematic review provides a comprehensive overview of the available clinical evidence for the use of DMN to treat various skin conditions. According to the PRISMA statement, a systematic search for articles on the use of DMN for dermatological indications was conducted on three different databases (Pubmed, Embase, and the Cochrane library). Only human clinical trials were considered. Qualitative assessment was done by two separate reviewers using the Cochrane risk of bias (RoB 2) and Chambers' criteria assessment tools. The search yielded 1090 articles. After deduplication and removal of ineligible records, 889 records were screened on title and abstract. Full text screening was done for 18 articles and ultimately 17 articles were included of which 15 were randomized controlled trials and two were case series. The quality assessment showed that the majority of included studies had low to no risk of bias. Clinical data supports that DMN are an excellent, effective, and pain free drug delivery method for multiple dermatological disorders including skin aging, hyperpigmentation, psoriasis, warts, and keloids by supplying a painless and effective vehicle for intradermal/intralesional drug administration. Microneedle technology provides a promising non- to minimally-invasive alternative to percutaneous injection.
经皮注射的皮内和透皮给药是有效的,但被认为是痛苦的,不方便的,此外还会产生生物危害性废物。与注射相比,局部药物应用,包括软膏、乳膏和洗剂,增加了局部药物负荷。此外,与全身给药相比,它的副作用较小。然而,表皮对高分子物质构成屏障,限制了传递效率。溶解微针(DMN)是亲水性的,主要基于聚合物的构建体,能够穿透皮肤,被开发用于提供无痛和直接的皮肤药物传递。本系统评价提供了关于 DMN 用于治疗各种皮肤疾病的临床证据的综合概述。根据 PRISMA 声明,在三个不同的数据库(Pubmed、Embase 和 Cochrane 图书馆)上对关于 DMN 用于皮肤科适应证的文章进行了系统搜索。只考虑了人类临床试验。两名独立评审员使用 Cochrane 偏倚风险(RoB 2)和 Chambers 标准评估工具对定性评估进行了评估。搜索产生了 1090 篇文章。经过去重和删除不合格记录后,对 889 篇标题和摘要进行了筛选。对 18 篇文章进行了全文筛选,最终纳入了 17 篇文章,其中 15 篇为随机对照试验,2 篇为病例系列。质量评估显示,大多数纳入的研究具有低至无偏倚风险。临床数据支持 DMN 是一种极好的、有效的、无痛的药物输送方法,可用于多种皮肤科疾病,包括皮肤老化、色素沉着过度、银屑病、疣和瘢痕疙瘩,通过为皮内/皮内药物给药提供无痛和有效的载体。微针技术为经皮注射提供了一种有前途的非侵入性或微创替代方法。
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