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Editors Selection IGR 17-1
Medical treatment: Long-acting drug delivery
Comment by Jose-Maria Martinez de la Casa on:
59114 Targeted delivery of antiglaucoma drugs to the supraciliary space using microneedles, Kim YC; Edelhauser HF; Prausnitz MR, Investigative Ophthalmology and Visual Science, 2014; 55: 7387-7397
Glaucoma is a chronic disease that requires chronic treatment. Two important problems that may result in deficient glaucoma control are patient non-adherence to treatment and the low bioavailability of topical drugs.
In this article, Kim et al. assess the efficiency of the supraciliary injection of anti-glaucoma agents as an alternative to topical administration such that the drug is delivered closer to its site of action. Their study was carefully designed with strict control of some of the variables that could affect intraocular pressure readings such as the type of anaesthetic used and prior calibration of the rebound tonometers used in the study.
Their results show that the targeted delivery of anti-glaucoma drugs using micro-needles in the New-Zealand White rabbit enables a significant reduction in the dose used. For one of the drugs tested, sulprostone, the dose needed for a similar pharmacodynamic response to that achieved via its topical administration was around 100-fold lower, while for the other drug tested, brimonidine, this dose was 115-fold lower. Thus substantial differences exist between the two routes of administration even if we consider that the supraciliary formulation contained as vehicle 2% carboxymethylcelullose to increase the viscosity and therefore the persistence of the drug following its injection.
Future work is needed to assess the efficacy and safety of this administration route in humans. The method proposed seems an interesting option that opens an array of possibilities to improve the performance of anti-glaucoma treatment. Finding formulations that given by this route will enable the controlled release of drugs could substantially improve the quality of life of patients with glaucoma.
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