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Best Practice & Research. Clinical... Jul 2020Unplanned pregnancy (UP) is a public health problem, which affects millions of women worldwide. Providing long-acting reversible contraceptive (LARC) methods is an... (Review)
Review
Unplanned pregnancy (UP) is a public health problem, which affects millions of women worldwide. Providing long-acting reversible contraceptive (LARC) methods is an excellent strategy to avoid or at least reduce UP, because the effectiveness of these methods is higher than other methods, and is indeed comparable to that of permanent contraception. As the initial introduction of the inert plastic intrauterine device (IUD) and of the six-rod implant, pharmaceutical companies have introduced a copper IUD (Cu-IUD), different models of levonorgestrel-releasing intrauterine system (LNG IUS), and one and two-rod implants, which certainly improved women's LARC options. The main characteristic of LARCs is that they provide high contraceptive effectiveness with a single intervention, and that they can be used for a long time. Emerging evidence from the last few years has demonstrated that it is possible to extend the use of the 52 mg LNG IUS and of the etonogestrel-implant beyond five- and three years, respectively, which adds new value to these LARCs.
Topics: Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptive Devices; Drug Implants; Female; Humans; Intrauterine Devices, Copper; Intrauterine Devices, Medicated; Levonorgestrel; Pregnancy; Pregnancy, Unplanned
PubMed: 32014434
DOI: 10.1016/j.bpobgyn.2019.12.002 -
Primary Care Dec 2021Nexplanon is the only contraceptive implant currently available in the United States. It exerts its contraceptive effects primarily by suppressing ovulation. The... (Review)
Review
Nexplanon is the only contraceptive implant currently available in the United States. It exerts its contraceptive effects primarily by suppressing ovulation. The Nexplanon is the most effective method of long-acting reversible contraception. The implant should be removed by the end of the third year of use. Persons will experience a rapid return to fertility once the implant is removed. All health care providers must be trained on Nexplanon before performing insertions or removals of the implant. A Nexplanon can be inserted and/or removed as an office-based procedure. The most common adverse reaction is change in menstrual bleeding patterns.
Topics: Contraceptive Agents, Female; Drug Implants; Female; Health Services; Humans; United States
PubMed: 34752268
DOI: 10.1016/j.pop.2021.07.002 -
AAPS PharmSciTech Sep 2019Implantable drug delivery systems, such as drug pumps and polymeric drug depots, have emerged as means of providing predetermined drug release profiles at the desired... (Review)
Review
Implantable drug delivery systems, such as drug pumps and polymeric drug depots, have emerged as means of providing predetermined drug release profiles at the desired site of action. While initial implants aimed at providing an enduring drug supply, developments in polymer chemistry and pharmaceutical technology and the growing need for refined drug delivery patterns have prompted the design of sophisticated drug delivery implants such as on-demand drug-eluting implants and personalized 3D printed implants. The types of cargo loaded into these implants range from small drug molecules to hormones and even therapeutic cells. This review will shed light upon recent advances in materials and composites used for polymeric implant fabrication, highlight select approaches employed in polymeric implant fabrication, feature medical applications where polymeric implants have a significant impact, and report recent advances made in these areas.
Topics: Animals; Drug Delivery Systems; Drug Implants; Drug Liberation; Humans; Infusion Pumps, Implantable; Polymers; Printing, Three-Dimensional; Technology, Pharmaceutical
PubMed: 31482251
DOI: 10.1208/s12249-019-1510-0 -
Veterinary Ophthalmology Mar 2021Barriers to effective medical therapy are numerous and include difficulties with effective and sustained control of intraocular pressure (IOP) and adherence to... (Review)
Review
Barriers to effective medical therapy are numerous and include difficulties with effective and sustained control of intraocular pressure (IOP) and adherence to prescribed anti-glaucoma drop regimens. In an effort to circumvent these challenges, a number of new anti-glaucoma therapies with sustained effects have emerged. Methods for sustained delivery of prostaglandin analogs are being intensely investigated and many are in human clinical trials. Intracameral devices include the following: Allergan's Durysta Bimatoprost SR, Envisia Therapeutics' ENV515 travoprost implant, Glaukos' iDose , Ocular Therapeutix's OTX-TIC travoprost implant, and Santen's polycaprolactone implant with PGE2-derivative DE-117. Other prostaglandin-based technologies include Allergan's bimatoprost ring (placed in the conjunctival fornix), Ocular Therapeutics' OTX-TP intracanalicular travoprost implant, subconjunctival latanoprost in a liposomal formulation, and the PGE2 derivative PGN 9856-isopropyl ester that is applied to the periorbital skin. Exciting breakthroughs in gene therapy include using viral vectors to correct defective genes such as MYOC or to modulate gonioimplant fibrosis, CRISPR technology to edit MYOC or to alter aquaporin to reduce aqueous humor production, and siRNA technology to silence specific genes. Stem cell technology can repopulate depleted tissues or, in the case of Neurotech's Renexus® NT-501 intravitreal implant, serve as a living drug delivery device that continuously secretes neurotrophic factors. Other unique approaches involve nanotechnology, nasal sprays that deliver drug directly to the optic nerve and noninvasive alternating current stimulation of surviving cells in the optic nerve. Over time these modalities are likely to challenge the preeminent role that drops currently play in the medical treatment of glaucoma in animals.
Topics: Animals; Cell- and Tissue-Based Therapy; Delayed-Action Preparations; Drug Implants; Forecasting; Genetic Therapy; Glaucoma; Humans; Intraocular Pressure; Nanotechnology; Prostaglandins, Synthetic
PubMed: 33164328
DOI: 10.1111/vop.12843 -
Expert Opinion on Drug Delivery Oct 2022Implantable devices can be designed to release drugs to localized regions of tissue at sustained and reliable rates. Advances in polymer engineering have led to the... (Review)
Review
INTRODUCTION
Implantable devices can be designed to release drugs to localized regions of tissue at sustained and reliable rates. Advances in polymer engineering have led to the design and development of drug-loaded implants with predictable, desirable release profiles. Biodegradable polyesters exhibit chemical, physical, and biological properties suitable for developing implants for pain management, cancer therapy, contraception, antiviral therapy, and other applications.
AREAS COVERED
This article reviews the use of biodegradable polyesters for drug-loaded implants by discussing the properties of commonly used polymers, techniques for implant formulation and manufacturing, mechanisms of drug release, and clinical applications of implants as drug delivery devices.
EXPERT OPINION
Drug delivery implants are unique systems for safe and sustained drug release, providing high bioavailability and low toxicity. Depending on the implant design and tissue site of deployment, implants can offer either localized or systemic drug release. Due to the long history of use of degradable polyesters in medical devices, polyester-based implants represent an important class of controlled release technologies. Further, polyester-based implants are the largest category of drug delivery implants to reach the point of testing in humans or approval for human use.
Topics: Humans; Polyesters; Delayed-Action Preparations; Drug Implants; Drug Liberation; Polymers; Drug Delivery Systems
PubMed: 36197839
DOI: 10.1080/17425247.2022.2131768 -
Expert Opinion on Drug Delivery Oct 2022
Topics: Drug Delivery Systems; Drug Carriers; Drug Implants; Absorbable Implants
PubMed: 35929995
DOI: 10.1080/17425247.2022.2110065 -
Advanced Drug Delivery Reviews Dec 2020A broad range of medical devices initiate an immune reaction known as the foreign body response (FBR) upon implantation. Here, collagen deposition at the surface of the... (Review)
Review
A broad range of medical devices initiate an immune reaction known as the foreign body response (FBR) upon implantation. Here, collagen deposition at the surface of the implant occurs as a result of the FBR, ultimately leading to fibrous encapsulation and, in many cases, reduced function or failure of the device. Despite significant efforts, the prevention of fibrotic encapsulation has not been realized at this point in time. However, many next-generation medical technologies including cellular therapies, sensors and devices depend on the ability to modulate and control the FBR. For these technologies to become viable, significant advances must be made in understanding the underlying mechanism of this response as well as in the methods modulating this response. In this review, we highlight recent advances in the development of materials and coatings providing a reduced FBR and emphasize key characteristics of high-performing approaches. We also provide a detailed overview of the state-of-the-art in strategies relying on controlled drug release, the surface display of bioactive signals, materials-based approaches, and combinations of these approaches. Finally, we offer perspectives on future directions in this field.
Topics: Animals; Biocompatible Materials; Delayed-Action Preparations; Drug Implants; Fibrosis; Foreign-Body Reaction; Humans; Hydra; Inflammation Mediators; Polymers; Prostheses and Implants; Tissue Scaffolds
PubMed: 32553685
DOI: 10.1016/j.addr.2020.06.008 -
Post Reproductive Health Dec 2023
Topics: Humans; Estradiol; Follicle Stimulating Hormone; Drug Implants
PubMed: 37997701
DOI: 10.1177/20533691231214870 -
Expert Opinion on Drug Delivery Apr 2023It is widely acknowledged that cardiovascular diseases (CVDs) continue to be the leading cause of death globally. Furthermore, CVDs are the leading cause of diminished... (Review)
Review
INTRODUCTION
It is widely acknowledged that cardiovascular diseases (CVDs) continue to be the leading cause of death globally. Furthermore, CVDs are the leading cause of diminished quality of life for patients, frequently as a result of their progressive deterioration. Medical implants that release drugs into the body are active implants that do more than just provide mechanical support; they also have a therapeutic role. Primarily, this is achieved through the controlled release of active pharmaceutical ingredients (API) at the implementation site.
AREAS COVERED
In this review, the authors discuss drug-eluting stents, drug-eluting vascular grafts, and drug-eluting cardiac patches with the aim of providing a broad overview of the three most common types of cardiac implant.
EXPERT OPINION
Drug eluting implants are an ideal alternative to traditional drug delivery because they allow for accurate drug release, local drug delivery to the target tissue, and minimize the adverse side effects associated with systemic administration. Despite the fact that there are still challenges that need to be addressed, the ever-evolving new technologies are making the fabrication of drug-eluting implants a rewarding therapeutic endeavor with the possibility for even greater advances.
Topics: Humans; Cardiovascular Diseases; Pharmaceutical Preparations; Quality of Life; Drug Delivery Systems; Drug-Eluting Stents; Drug Implants
PubMed: 36924328
DOI: 10.1080/17425247.2023.2190580 -
Expert Opinion on Drug Delivery May 2021: Drug eluting implants offer patient convenience and improved compliance through less frequent dosing, eliminating repeated, painful injections and providing localized,... (Review)
Review
: Drug eluting implants offer patient convenience and improved compliance through less frequent dosing, eliminating repeated, painful injections and providing localized, site specific delivery with applications in contraception, ophthalmology, and oncology.: This review provides an overview of available implant products, design approaches, biodegradable and non-biodegradable polymeric materials, and fabrication techniques with a focus on commercial applications and industrial drug product development. Developing trends in the field, including expanded availability of suitable excipients, development of novel materials, scaled down manufacturing process, and a wider understanding of the implant development process are discussed and point to opportunities for differentiated drug eluting implant products.: In the future, long-acting implants will be important clinical tools for prophylaxis and treatment of global health challenges, especially for infectious diseases, to reduce the cost and difficulty of treating chronic indications, and to prolong local delivery in difficult to administer parts of the body. These products will help improve patient safety, adherence, and comfort.
Topics: Drug Delivery Systems; Drug Development; Drug Implants; Excipients; Humans; Pharmaceutical Preparations
PubMed: 33275066
DOI: 10.1080/17425247.2021.1856072