Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient
Advances in our understanding of the biology of spinal systems in organizing and defining the content of exteroceptive information upon which higher centers define the state of the organism and its role in the regulation of somatic and automatic output, defining the motor response of the organism, a...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Pain Research |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpain.2022.900566/full |
| _version_ | 1827969176603459584 |
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| author | Jose De Andres Jose De Andres Salim Hayek Christophe Perruchoud Christophe Perruchoud Melinda M. Lawrence Miguel Angel Reina Miguel Angel Reina Miguel Angel Reina Miguel Angel Reina Carmen De Andres-Serrano Ruben Rubio-Haro Ruben Rubio-Haro Mathew Hunt Tony L. Yaksh |
| author_facet | Jose De Andres Jose De Andres Salim Hayek Christophe Perruchoud Christophe Perruchoud Melinda M. Lawrence Miguel Angel Reina Miguel Angel Reina Miguel Angel Reina Miguel Angel Reina Carmen De Andres-Serrano Ruben Rubio-Haro Ruben Rubio-Haro Mathew Hunt Tony L. Yaksh |
| author_sort | Jose De Andres |
| collection | DOAJ |
| description | Advances in our understanding of the biology of spinal systems in organizing and defining the content of exteroceptive information upon which higher centers define the state of the organism and its role in the regulation of somatic and automatic output, defining the motor response of the organism, along with the unique biology and spatial organization of this space, have resulted in an increased focus on therapeutics targeted at this extracranial neuraxial space. Intrathecal (IT) drug delivery systems (IDDS) are well-established as an effective therapeutic approach to patients with chronic non-malignant or malignant pain and as a tool for management of patients with severe spasticity and to deliver therapeutics that address a myriad of spinal pathologies. The risk to benefit ratio of IDD makes it a useful interventional approach. While not without risks, this approach has a significant therapeutic safety margin when employed using drugs with a validated safety profile and by skilled practioners. The present review addresses current advances in our understanding of the biology and dynamics of the intrathecal space, therapeutic platforms, novel therapeutics, delivery technology, issues of safety and rational implementation of its therapy, with a particular emphasis upon the management of pain. |
| first_indexed | 2024-04-09T18:33:55Z |
| format | Article |
| id | doaj.art-37c73257a95a437ab950cb72da0fcd81 |
| institution | Directory Open Access Journal |
| issn | 2673-561X |
| language | English |
| last_indexed | 2024-04-09T18:33:55Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pain Research |
| spelling | doaj.art-37c73257a95a437ab950cb72da0fcd812023-04-11T13:50:15ZengFrontiers Media S.A.Frontiers in Pain Research2673-561X2022-06-01310.3389/fpain.2022.900566900566Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain PatientJose De Andres0Jose De Andres1Salim Hayek2Christophe Perruchoud3Christophe Perruchoud4Melinda M. Lawrence5Miguel Angel Reina6Miguel Angel Reina7Miguel Angel Reina8Miguel Angel Reina9Carmen De Andres-Serrano10Ruben Rubio-Haro11Ruben Rubio-Haro12Mathew Hunt13Tony L. Yaksh14Surgical Specialties Department, Valencia University Medical School, Valencia, SpainAnesthesia Critical Care and Pain Management Department, Valencia, SpainDepartment of Anesthesiology, University Hospitals Cleveland Medical Center, Cleveland, OH, United StatesPain Center and Department of Anesthesia, La Tour Hospital, Geneva, SwitzerlandLausanne University Hospital and University of Lausanne, Lausanne, SwitzerlandDepartment of Anesthesiology, University Hospitals Cleveland Medical Center, Cleveland, OH, United StatesDepartment of Anesthesiology, Montepríncipe University Hospital, Madrid, SpainCEU-San-Pablo University School of Medicine, Madrid, SpainDepartment of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, United StatesFacultad de Ciencias de la Salud Universidad Francisco de Vitoria, Madrid, Spain0Multidisciplinary Pain Clinic, Vithas Virgen del Consuelo Hospital, Valencia, Spain1Anesthesia and Pain Management Department, Provincial Hospital, Castellon, Spain2Multidisciplinary Pain Clinic, Vithas Virgen del Consuelo Hospital, Valencia, Spain3Department of Physiology, Karolinska Institute, Stockholm, Sweden4Departments of Anesthesiology and Pharmacology, University of California, San Diego, San Diego, CA, United StatesAdvances in our understanding of the biology of spinal systems in organizing and defining the content of exteroceptive information upon which higher centers define the state of the organism and its role in the regulation of somatic and automatic output, defining the motor response of the organism, along with the unique biology and spatial organization of this space, have resulted in an increased focus on therapeutics targeted at this extracranial neuraxial space. Intrathecal (IT) drug delivery systems (IDDS) are well-established as an effective therapeutic approach to patients with chronic non-malignant or malignant pain and as a tool for management of patients with severe spasticity and to deliver therapeutics that address a myriad of spinal pathologies. The risk to benefit ratio of IDD makes it a useful interventional approach. While not without risks, this approach has a significant therapeutic safety margin when employed using drugs with a validated safety profile and by skilled practioners. The present review addresses current advances in our understanding of the biology and dynamics of the intrathecal space, therapeutic platforms, novel therapeutics, delivery technology, issues of safety and rational implementation of its therapy, with a particular emphasis upon the management of pain.https://www.frontiersin.org/articles/10.3389/fpain.2022.900566/fullantisenseintrathecalneuromodulationchronic painimplantable drug delivery system (IDDS) |
| spellingShingle | Jose De Andres Jose De Andres Salim Hayek Christophe Perruchoud Christophe Perruchoud Melinda M. Lawrence Miguel Angel Reina Miguel Angel Reina Miguel Angel Reina Miguel Angel Reina Carmen De Andres-Serrano Ruben Rubio-Haro Ruben Rubio-Haro Mathew Hunt Tony L. Yaksh Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient Frontiers in Pain Research antisense intrathecal neuromodulation chronic pain implantable drug delivery system (IDDS) |
| title | Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient |
| title_full | Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient |
| title_fullStr | Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient |
| title_full_unstemmed | Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient |
| title_short | Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient |
| title_sort | intrathecal drug delivery advances and applications in the management of chronic pain patient |
| topic | antisense intrathecal neuromodulation chronic pain implantable drug delivery system (IDDS) |
| url | https://www.frontiersin.org/articles/10.3389/fpain.2022.900566/full |
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