Advanced implantable drug delivery technologies: transforming the clinical landscape of therapeutics for chronic diseases

Abstract

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.

Preventive efficacy of a tenofovir alafenamide fumarate nanofluidic implant in SHIV-challenged nonhuman primates

“…In this foremost study, the partial protection of simian HIV with tenofovir alafenamide (TAF) delivered by a nanofluidic implant was demonstrated in nonhuman primates. 13 , K. Jagannadha Sastry 3,14 , Alessandro Grattoni 1,15,16 * 809…”

“…In the case of LA ARV implants, a single drug formulation affords smaller size dimensions for minimally-invasive and discreet implantation. [16,17] Importantly, single-agent LA ARVs offer benefits of cost-effectiveness as well as reduced complexity in terms of development. Of relevance, a single-agent injectable LA ARV, cabotegravir, is currently in clinical trials for PrEP efficacy evaluation (NCT02076178, NCT02178800, NCT02720094, NCT03164564).…”

Emerging Technologies for Local Cancer Treatment

“…[159,160] While these recent advances in local drug delivery technologies are seemingly poised to offer unparalleled opportunities to transform cancer treatment approaches, regulatory hurdles need to be addressed prior to clinical translation. Cumulative efforts in controlled drug delivery research [161] along with advances in therapeutic oncology, [162][163][164] have better equipped us to devise more effective local delivery systems, confront translational hurdles, and provide safer solutions for cancer treatment.…”

Design of a Drug-Eluting Subcutaneous Implant of the Antiretroviral Tenofovir Alafenamide Fumarate

“…Norplant-II™ contraceptive implants consisted of two 2.4 mm diameter 4.4 cm long rods (35). Implanon™ is a single rod 2 mm in diameter and 4 cm long (22). The Supprelin™ LA and Vantas™ histrelin acetate implants are 3 mm diameter and 3.5 cm long (22).…”

“…Pons-Faudoa et al have recently reviewed reservoir implant designs (22). Several attempts have been made to develop subcutaneous implants that achieve the controlled release of ARV drugs for prevention.…”