Translational medicine in the field of ablative fractional laser (AFXL)-assisted drug delivery: A critical review from basics to current clinical status - 14/04/16
Abstract |
Background |
Ablative fractional lasers enhance uptake of topical therapeutics and the concept of fractional laser-assisted drug delivery has now been taken into clinical practice.
Objectives |
We systematically reviewed preclinical data and clinical evidence for fractional lasers to enhance drug uptake and improve clinical efficacy.
Methods |
We searched PubMed and Embase databases; 34 articles met the inclusion criteria. Studies were categorized into experimental preclinical studies and clinical trials, the latter graded according to level of evidence.
Results |
All preclinical trials (n = 16) documented enhanced topical drug uptake into skin after ablative fractional laser treatment. Clinical evidence encompassed 18 studies, of which 9 were randomized controlled trials and 2 were controlled trials, examining neoplastic lesions, photodamaged skin, scars, onychomycosis, and topical anesthetics. The highest level of evidence was reached for actinic keratoses treated with methylaminolevulinate for photodynamic therapy (level IB, 5 randomized controlled trials), substantiating superior and long-lasting efficacy versus conventional photodynamic therapy. No adverse events were reported, but ablative fractional laser–assisted drug delivery implies risks of systemic drug absorption, especially when performed over large skin areas.
Conclusions |
Fractional laser-assisted drug delivery is beneficial in enhancing preclinical and clinical outcomes for certain skin conditions.
Le texte complet de cet article est disponible en PDF.Key words : ablative fractional laser, cutaneous, drug delivery, laser, laser-assisted drug delivery, topical administration, transcutaneous
Abbreviations used : AFXL, AK, ALA, BCC, MAL, MAZ, MTX, PDT, RCT
Plan
Funding sources: None. |
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Conflicts of interest: None declared. |
Vol 74 - N° 5
P. 981-1004 - mai 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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