ABSTRACT

Introduction

As research in suprachoroidal drug delivery advances, and therapeutic candidates, ranging from small molecule suspensions to gene therapy, progress through clinical trials, an understanding of suprachoroidal space (SCS) biomechanics assumes increasing importance.Areas covered:Numerous anatomic features play an important role in therapeutic access to the SCS. Methods of access include a catheter, a standard hypodermic needle, and a microinjector with microneedle. Physical and fluidic properties of injectates into the SCS, such as volume, viscosity, particle size, osmotic pressure, and ionic charge of formulation can impact the spread and extent of opening of the SCS. Pharmacokinetic data of several small molecule suspensions yielded favorable ocular distribution and pharmacokinetic profiles. Phase 2 and 3 clinical trials have been completed with a suprachoroidally injected corticosteroid; results and information on procedural details with the microinjector are discussed.

Expert opinion

Suprachoroidal drug delivery has been demonstrated to be a reliable and consistent drug delivery method for targeted treatment of retinal and choroidal disorders to potentially maximize efficacy, while compartmentalizing therapies away from the unaffected tissues to potentially enhance safety. These delivery attributes, along with fluid transport properties and formula customization for pharmacological agents, may allow for more tailored treatment of diseases affecting chorio-retinal tissues.

中文翻译：

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脉络膜上膜给药的生物力学：从台式到眼部治疗的临床研究

摘要

介绍

随着脉络膜上膜药物递送研究的进展，以及从小分子悬浮液到基因治疗的候选治疗药物，通过临床试验取得进展，对脉络膜上腔 (SCS) 生物力学的理解变得越来越重要。涉及领域：许多解剖特征在 SCS 的治疗通路中发挥着重要作用。访问方法包括导管、标准皮下注射针和带有微针的显微注射器。注入 SCS 的物理和流体特性，例如体积、粘度、粒度、渗透压和制剂的离子电荷，会影响 SCS 的扩散和打开程度。几种小分子悬浮液的药代动力学数据产生了良好的眼部分布和药代动力学特征。脉络膜上注射皮质类固醇已完成二期和三期临床试验；讨论了有关显微注射器的程序细节的结果和信息。

专家意见

脉络膜上给药已被证明是一种可靠且一致的给药方法，可用于视网膜和脉络膜疾病的靶向治疗，以最大限度地提高疗效，同时将治疗与未受影响的组织分开，以潜在地提高安全性。这些递送特性，连同流体输送特性和药物制剂的配方定制，可能允许对影响脉络膜视网膜组织的疾病进行更量身定制的治疗。