Department of Bioengineering, Rice University, Houston, TX, USA.
David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA.
Nat Rev Drug Discov. 2023 May;22(5):387-409. doi: 10.1038/s41573-023-00670-0. Epub 2023 Mar 27.
Poor medication adherence is a pervasive issue with considerable health and socioeconomic consequences. Although the underlying reasons are generally understood, traditional intervention strategies rooted in patient-centric education and empowerment have proved to be prohibitively complex and/or ineffective. Formulating a pharmaceutical in a drug delivery system (DDS) is a promising alternative that can directly mitigate many common impediments to adherence, including frequent dosing, adverse effects and a delayed onset of action. Existing DDSs have already positively influenced patient acceptability and improved rates of adherence across various disease and intervention types. The next generation of systems have the potential to instate an even more radical paradigm shift by, for example, permitting oral delivery of biomacromolecules, allowing for autonomous dose regulation and enabling several doses to be mimicked with a single administration. Their success, however, is contingent on their ability to address the problems that have made DDSs unsuccessful in the past.
药物依从性差是一个普遍存在的问题,会产生相当大的健康和社会经济后果。尽管其根本原因通常为人所知,但以患者为中心的教育和赋权为基础的传统干预策略被证明过于复杂和/或无效。将药物制成药物输送系统(DDS)是一种很有前途的替代方法,可以直接减轻许多常见的依从性障碍,包括频繁给药、不良反应和作用延迟。现有的 DDS 已经对患者的可接受性产生了积极影响,并提高了各种疾病和干预类型的依从率。下一代系统有可能通过例如允许生物大分子的口服给药、允许自主剂量调节以及能够用单次给药模拟多次给药等方式,引入更激进的范式转变。然而,它们的成功取决于它们解决过去使 DDS 不成功的问题的能力。