Implantable medical devices have revolutionized modern medicine. However, immune-mediated foreign body response (FBR) to the materials of these devices can limit their function or even induce failure. Here we describe long-term controlled release formulations for local antiinflammatory release through the development of compact, solvent-free crystals. The compact lattice structure of these crystals allows for very slow, surface dissolution and high drug density. These formulations suppress FBR in both rodents and non-human primates for at least 1.3 years and 6 months, respectively. Formulations inhibited fibrosis across multiple implant sitessubcutaneous, intraperitoneal and intramuscular. In particular incorporation of GW2580, a Colony Stimulating Factor 1 Receptor (CSF1R) inhibitor, into a range of devices including human islet microencapsulation systems, electrode-based continuous glucose-sensing monitors and musclestimulating devices, inhibits fibrosis, thereby allowing for extended function. We believe that local, long-term controlled release with the crystal formulations described here enhances and extends function in a range of medical devices and provides a generalized solution to the local immune response to implanted biomaterials. Implanted biomedical devices are an integral part of modern therapeutics, playing key roles in many clinical applications including neural interfacing 1 , monitoring vital signs 2 , pacemakers 3 , controlled drug release 4 , scaffolds for tissue reconstruction 5 , vascular stenting, cell encapsulation and transplantation 6. While the immunological response to materials can be therapeutic, for example with particulate vaccines 7 , some device materials, including polysaccharides, polymers, ceramics, and metals 8 , can induce host immune-mediated foreign body and rejection responses This response can lead to fibrotic encapsulation, and in some cases, reduced efficacy or failure 8-12. Current approaches for long-term maintenance of biomedical device implant biocompatibility often involve broad-spectrum antiinflammatories 13. Short-term steroid or anti-fibrotic drug delivery can transiently inhibit inflammatory cell recruitment as well as improve protein secretion of immuno-isolated cellular grafts 14,15. However, many anti-inflammatory drugs have multiple targets and differential effects in vivo, and associated toxicity 13,16. In particular, macrophages are known to be key mediators of the immune response to implanted biomaterials 8-10. Recently it was shown that the implant-induced foreign body response can be inhibited through selective targeting of the monocyte/macrophage-expressed colony stimulating factor-1 (CSF1R) receptor 10. Importantly, while macrophage numbers in the IP space as well as Farah et al.