New Drug Delivery Systems in Inflammatory Bowel Disease: MMX™ and Tailored Delivery to the Gut

被引:32
作者
Fiorino, G.
Fries, W. [2 ]
De La Rue, S. A.
Malesci, A. C. [3 ]
Repici, A.
Danese, S. [1 ]
机构
[1] IRCCS Gastroenterol, Ist Clin Humanitas, Gastroenterol Unit, Div Gastroenterol, Milan, Italy
[2] Univ Messina, Dept Internal Med & Med Therapy, Messina, Italy
[3] Univ Milan, Dept Translat Med, Milan, Italy
关键词
Multimatrix; MMX; Crohn; Colitis; IBD; mesalamine; budesonide; heparin; ACTIVE ULCERATIVE-COLITIS; MOLECULAR-WEIGHT HEPARIN; DAILY MMX MESALAZINE; 5-AMINOSALICYLIC ACID; MILD; RELEASE; MESALAMINE; REMISSION; ACETYLATION; BUDESONIDE;
D O I
10.2174/092986710791111170
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Inflammatory bowel diseases are chronic diseases that affect the gastrointestinal tract. Mesalamine, corticosteroids, immunosuppressants and biological agents are currently used to treat these diseases. Due to inadequacies of the currently available delivery systems, a large number of patients do not respond to treatment, especially when they are affected by distal colonic disease. Multimatrix (MMX (TM)) technology comprises hydrophilic and lipophilic excipients, enclosed within a gastro-resistant, pH-dependent coating. This new delivery technology has been used to modify some commonly used drugs, including mesalamine and budesonide, as well as heparin, which are now being investigated for their utility in the management of IBD. Aim: The aim of this review is to explore the MMX delivery technology and its efficacy for the treatment of IBD. Results: The results of various studies involving MMX drugs have been published. Mesalamine MMX induces clinical and endoscopic remission in patients with mild to moderate ulcerative colitis (UC) compared with placebo. Positive results have also been observed with MMX budesonide in two phase I studies. In a pilot study involving ten patients with UC, efficacy of heparin-MMX as an IBD therapy was observed. Conclusion: MMX is a promising new delivery system that can improve efficacy of current and new drugs, augmenting targeting to the affected tract, thereby increasing response and remission rates for those drugs in patients with IBD.
引用
收藏
页码:1851 / 1857
页数:7
相关论文
共 29 条
[1]   Gastrointestinal transit, release and plasma pharmacokinetics of a new oral budesonide formulation [J].
Brunner, M ;
Ziegler, S ;
Di Stefano, AFD ;
Dehghanyar, P ;
Kletter, K ;
Tschurlovits, M ;
Villa, R ;
Bozzella, R ;
Celasco, G ;
Moro, L ;
Rusca, A ;
Dudczak, R ;
Müller, M .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2006, 61 (01) :31-38
[2]   Guidelines for the management of inflammatory bowel disease in adults [J].
Carter, MJ ;
Lobo, AJ ;
Travis, SPL .
GUT, 2004, 53 :v1-v16
[3]   Efficacy of Intracolonic Administration of Low-Molecular-Weight Heparin CB-01-05, Compared to Other Low-Molecular-Weight Heparins and Unfractionated Heparin, in Experimentally Induced Colitis in Rat [J].
Celasco, Giuseppe ;
Moro, Luigi ;
Bozzella, Roberta ;
Mangano, Katia ;
Quattrocchi, Cinzia ;
Aiello, Caterina ;
Donia, Marco ;
Fagone, Paolo ;
Di Marco, Roberto .
DIGESTIVE DISEASES AND SCIENCES, 2008, 53 (12) :3170-3175
[4]   Once daily MMX mesalazine for the treatment of mild-to-moderate ulcerative colitis: a phase II, dose-ranging study [J].
D'Haens, G. ;
Hommes, D. ;
Engels, L. ;
Baert, F. ;
Van der Waaij, L. ;
Connor, P. ;
Ramage, J. ;
Dewit, O. ;
Palmen, M. ;
Stephenson, D. ;
Joseph, R. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2006, 24 (07) :1087-1097
[5]   Review article: mode of action and delivery of 5-aminosalicylic acid - new evidence [J].
Desreumaux, P. ;
Ghosh, S. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2006, 24 :2-9
[6]  
DHAENS G, 2007, J CROHN COLITIS, V1
[7]   Gut delivery of budesonide, a locally active corticosteroid, from plain and controlled-release capsules [J].
Edsbäcker, S ;
Larsson, P ;
Wollmer, P .
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2002, 14 (12) :1357-1362
[8]   Mucosal 5-aminosalicylic acid concentration inversely correlates with severity of colonic inflammation in patients with ulcerative colitis [J].
Frieri, G ;
Giacomelli, R ;
Pimpo, M ;
Palumbo, G ;
Passacantando, A ;
Pantaleoni, G ;
Caprilli, R .
GUT, 2000, 47 (03) :410-414
[9]  
Gionchetti P, 1999, ALIMENT PHARM THERAP, V13, P381
[10]  
Hein DW, 2000, CANCER EPIDEM BIOMAR, V9, P29