Laser microporation facilitates topical drug delivery: a comprehensive review about preclinical development and clinical application

ABSTRACT

Introduction

Topical drug delivery is highly attractive and yet faces tissue barrier challenges. Different physical and chemical methods have been explored to facilitate topical drug delivery.

Areas covered

Ablative fractional laser (AFL) has been widely explored by the scientific community and dermatologists to facilitate topical drug delivery since its advent less than two decades ago. This review introduces the major efforts in exploration of AFL to facilitate transdermal, transungual, and transocular drug delivery in preclinical and clinical settings.

Expert opinion

Most of the preclinical and clinical studies find AFL to be safe and highly effective to facilitate topical drug delivery with little restriction on physicochemical properties of drugs. Clinical studies support AFL to enhance drug efficacy, shorten treatment time, reduce pain, improve cosmetic outcomes, reduce systemic drug exposure, and improve safety. Considering most of the clinical trials so far involved a small sample size and were in early phase, future trials will benefit from enrolling a large group of patients for thorough evaluation of the safety and efficacy of AFL-assisted topical drug delivery. The manufacturing of small and less costly AFL devices will also facilitate the translation of AFL-assisted topical drug delivery.

KEYWORDS:

• Ablative fractional laser
• AFL
• Transdermal
• Topical
• Ocular
• Transungual
• Microchannel
• Micropore
• Sustained drug delivery
• Laser

Article highlights

• This review introduces preclinical development and clinical evaluation of ablative fractional laser to facilitate transdermal/transungual/transocular drug delivery.

• Ablative fractional laser allows efficient delivery of small chemicals, biologics, nano- and microparticles, and even live cells with little restriction on physicochemical properties of drugs.

• Ablative fractional laser allows rapid drug penetration to deep tissue layers and is promising to enhance drug efficacy, shorten treatment time, reduce pain, and improve cosmetic outcomes.

• Ablative fractional laser-assisted topical drug delivery enables quick and complete tissue recovery and is well-tolerated in humans.

• The development of small, cost-effective ablative fractional laser devices is expected to facilitate its clinical translation in topical drug delivery.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded by the National Institutes of Health (NIH). X Chen received grant support NIH (AI139473 and AI156510). J Voyer received support from the URI MARC U*STAR grant from the National Institute of General Medical Sciences of the National Institutes of Health under grant number T34GM131948.